Your symptom score explained

Twenty-seven symptoms, each rated None, Mild, Moderate or Severe. None counts 0, Severe counts 3, and the total runs from 0 to 81. That is Roshara's symptom score, and it takes a few minutes on your phone.

Signed out, the sum is worked out on the page and nothing you tick is sent or stored. Signed in, you can save a score to your account and see your saved scores side by side.

It is a record, not a test. It cannot tell you whether you are in perimenopause, and it does not diagnose anything.

How the list was built

The 27 symptoms sit in four groups: heat, heart and sleep; mood and mind; body and joints; and periods, bladder and sexual health. The list is Roshara's own. It draws on a standard menopause symptom scale, the symptoms NICE NG23 tells doctors to explain (changes in periods, hot flushes and sweats, vaginal dryness, effects on mood, joint and muscle pain, low sexual desire), and the early symptoms in the Pakistan Menopause Society's Table 1, which is where bloating, breast tenderness and weight gain come from.

Under most labels sits a short hint in the words women use, so a symptom you would never have called by its medical name still gets counted.

Why there are no bands

You will not see "mild", "moderate" or "severe" stamped on your total. A cut-off would invite you to read your number against everyone else's, and the score is not built for that. It is built for comparison with yourself: today, and again after a change.

The Pakistan Menopause Society's recommendations name two structured scales a doctor might use to record symptoms: the Menopause Rating Scale, known as the MRS, and the MENQOL questionnaire. The MRS rates 11 symptoms, each from 0 to 4. If your doctor hands you one of these, fill it in. It does a similar job to Roshara's score, on a different list.

The same recommendations ask doctors to cover every group of symptoms, not just the ones a woman raises, because many may not mention bladder, sexual or mood symptoms unless asked in private. A score you filled in at home puts those on paper before you have to say them out loud.

Take the score before an appointment and bring it with you. Print it, save it as a PDF, or show it on your phone. Your answers come out worst first, so the symptoms bothering you most are at the top of the page.

If you start a treatment, take it again later. NICE NG23 recommends reviewing a menopause treatment at three months, and a score from before and one from three months in gives you and your doctor something concrete to compare. Between scores, symptom tracking day by day fills in the weeks.

A high score is not an emergency in itself. Some things are, and none of them should wait for a score. Bleeding after your periods have stopped is one: the Pakistan Menopause Society lists it among the red flags that need checking (section 2.3). Breathlessness at rest, or breathlessness with chest pain, is another: see a doctor straight away.