For each question CIRCLE the number that best applies to your experience with that symptom over the past 3 months.

0 - Never or rarely – It is rare to experience this symptom.

1 - Occasionally – Once in awhile you may experience this – maybe once or twice a month.

2 - Often – You experience this 1-2 times a week, enough that it bothers you.

3 - Regularly – You are constantly aware of this as it occurs almost every day or weekly.

243. Hair growth on face or body

244. Masculine tendencies

245. Tendency towards anemia

246. Premenstrual tension or anxiety

247. Painful menses

248. Depressed and/or angry, resentful feelings before menstruation

249. Menstruation excessive and prolonged

250. Headaches during time of menses

251. Painful breasts

252. Menstruate too frequently

253. Vaginal discharge

254. Hysterectomy/ovaries removed

255. Menopausal hot flashes

256. Menses scanty or missed

257. Acne worse during menses

258. Long Term Depression

259. Dry vaginal tract

260. Sexual intercourse painful or uncomfortable

261. Nausea and/or vomiting during menstruation

262. Diminished sex drive

Total Score for Group 10F