Take our SURVEY...

Do You Use Alternative Medicine
for Menopause Symptoms and Concerns ?

YOUR ANSWERS ARE CONFIDENTIAL AND WILL NOT BE SHARED WITH ANY ONE ELSE 

Have You Had Menopausal Symptoms or Concerns Within the Past Year? If So, Please Take Our Survey.


What Are You Doing For Your Symptoms or Concerns?

Hormone Therapy Alternative Therapy Both Therapies Neither Therapy

 


If You Have Used Alternative Therapy, or Both Therapies Please Select From The
Following List of Symptoms or Concerns. Choose the Alternative Treatments you Have Used.


SYMPTOMS:
Hot Flashes
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Period Changes
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Anxiety
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Fatigue
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Mood Swings
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Forgetfulness
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Insomnia
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Weight Gain
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Vaginal Dryness
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Headache
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Night Sweats
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Depression
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
CONCERNS:
Osteoporosis
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
Heart Disease
Yes No
Select Treatments:
Herbs
Calcium
Vitamin/supplement other than Calcium
Proper nutrition/Diet

 
Exercise
Acupuncture
Relaxation/Meditation
Homeopathy
ADDITIONAL COMMENTS ?
DEMOGRAPHICS:
Age Race
Education Household Income
State/Country
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