What would your life be like without fibroids?

Having fibroids in your uterus can affect your quality of life:

  • It can lead to worry.
  • It can limit your activities.
  • It can influence your mood, your self-confidence and your self-control.
  • It can affect your sexual activity.

Answer our questionnaire and discover how fibroids are affecting your day-to-day.

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Step 1

During the past three months, to what extent negatively affected you:

  • Never
  • Nearly ever
  • Sometimes
  • Many times
  • Always

1. Heavy bleeding during your menstrual period

2. Passing blood clots during your menstrual period

3. Fluctuation in the duration of your menstrual period compared to your previous cycles

4. Fluctuation in the length of your monthly cycle compared to your previous cycles

5. Feeling tightness or pressure in your pelvic area

6. Frequent urination during the daytime hours

7. Frequent nighttime urination

8. Feeling fatigued

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Step 2

During the past three months, how often your symptoms related to fibroid/s ...

  • Never
  • Nearly ever
  • Sometimes
  • Many times
  • Always

9. Made you feel anxious about the unpredictable onset or duration of your periods?

10. Made you anxious about traveling?

11. Interfered with your physical activities?

12. Caused you to feel tired or worn out?

13. Made you decrease the amount of time you spent on exercise or other physical activities?

14. Made you feel as if you are not in control of your life?

15. Made you concerned about soiling underclothes?

16. Made you feel less productive?

17. Caused you to feel drowsy or sleepy during the day?

18. Made you feel self-conscious of weight gain?

19. Made you feel that it was difficult to carry out your usual activities?

20. Interfered with your social activities?

21. Made you feel conscious about the size and appearance of your stomach?

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Step 3

During the past three months, how often your symptoms related to fibroid/s ...

  • Never
  • Nearly ever
  • Sometimes
  • Many times
  • Always

22. Made you concerned about soiling bed linen?

23. Made you feel sad, discouraged, or hopeless?

24. Made you feel down hearted and blue?

25. Made you feel wiped out?

26. Caused you to be concerned or worried about your health?

27. Caused you to plan activities more carefully?

28. Made you feel inconvenienced about always carrying extra pads, tampons, and clothing to avoid accidents?

29. Caused you embarrassment?

30. Made you feel uncertain about your future?

31. Made you feel irritable?

32. Made you concerned about soiling outer clothes?

33. Affected the size of clothing you wear during your periods?

34. Made you feel that you are not in control of your health?

35. Made you feel weak as if energy was drained from your body?

36. Diminished your sexual desire?

37. Caused you to avoid sexual relations?

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