Question 1 of 8

During the past week how bothered have you been by intimate itching or irritation?

Not at all
A little bit
To some extent
A lot
Very much

Question 2 of 8

Would you say that you are experiencing intimate dryness?

Not at all
A little bit
To some extent
A lot
Very much

Question 3 of 8

Would you say that you are experiencing intimate itching?

Not at all
A little bit
To some extent
A lot
Very much

Question 4 of 8

To what extent are you experiencing itching in your intimate area?

Not at all
A little bit
To some extent
A lot
Very much

Question 5 of 8

Do you experience unwanted intimate odour?

Not at all
A little bit
To some extent
A lot
Very much

Question 6 of 8

Would you describe your intimate area as irritated?

Not at all
A little bit
To some extent
A lot
Very much

Question 7 of 8

Do you feel that the irritaion / itching or odour impact on your daily life?

Not at all
A little bit
To some extent
A lot
Very much

Question 8 of 8

Do you find that intimate problems place limitations on your everyday life?

Not at all
A little bit
To some extent
A lot
Very much
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