Question 1

Why ask so much before the consult?

Accepted Answer

Because it's hard to say everything in one conversation, and hard to remember what was said. In a US study of recorded clinic visits, doctors who asked patients why they'd come often interrupted, and half of those interruptions came within 11 seconds. In a UK study, only 4 out of 35 patients said everything they had come to say. And one review estimates that people forget 40 to 80% of what a doctor tells them. This isn't about doctors not caring. One conversation can't cover everything. In two Indian studies, primary care visits lasted about 2 minutes. A Yellow consult is longer than that. But you still don't want to spend it trying to remember when your periods changed. So you answer at home, in your own time, with your calendar and your reports open. Your doctor reads your answers before the call.

Question 2

Does writing it down help?

Accepted Answer

Yes, a little. When patients prepare before a consult, for example by writing down their questions, they ask more questions, and the consult doesn't take longer. A review of 33 trials found the effect is small. I'd rather tell you that than oversell it. Filling in a symptom questionnaire also makes it easier to bring up things you might not have mentioned. And it helps your doctor see which symptoms bother you most. That's what ours is for. It doesn't give you a score. It tells your doctor where to start.

Question 3

Can't a blood test tell if it's perimenopause?

Accepted Answer

Not on its own, at any age. Hormone levels go up and down a lot during perimenopause. So one test can come back normal in a month when you feel unwell. Under 45, a doctor may test your blood, alongside your symptoms and your periods. From 45, guidelines say a blood test isn't needed at all. Britain's NICE guideline says perimenopause is recognised without lab tests. India's menopause guideline says menopause is diagnosed from your periods, your age and your symptoms, and that FSH, oestradiol (estradiol) and AMH tests are not recommended for this. Age matters in India, because menopause comes earlier here: at 46.6 on average, about 4 to 5 years earlier than in white women in Western countries. Between 8% and 16% of Indian women reach menopause at 40 to 44. In a large US study, the years of change before the last period lasted a median of about 4 to 9 years. So in India, perimenopause can start in your late 30s or early 40s. India's guideline suggests paying attention to your health from 35. There's more in Is this perimenopause? and in our guide to hormone tests for perimenopause. Blood tests still matter for other things. Thyroid problems, low iron and low vitamin D cause many of the same symptoms. That's what the Yellow blood panel is for, and this guide covers which tests help after 40. So for perimenopause itself, what you tell your doctor matters more than a hormone test. That can be surprising if you've been told "your reports are normal".

Question 4

Why ask about 80 changes when I came for one?

Accepted Answer

Because perimenopause causes many more changes than hot flushes. Most Indian women in midlife notice changes, and the most common are in the body, like aching joints and poor sleep. Hot flushes are less common here than in Western countries. So if your joints hurt and you don't get hot flushes, that can still be perimenopause. Worldwide, joint and muscle pain is the most common midlife symptom. A review of 321 studies found it in 65% of women. Changes in different parts of the body can also be linked. In a study of women in Singapore, including Indian women, those with vaginal dryness or exhaustion were more likely to have joint pain. So the questionnaire asks about every area, not only the one that brought you in. Many women don't link these changes to perimenopause, as Asha didn't. And some changes don't get mentioned at all. A 2025 study at clinics across India found the vaginal and urinary changes of menopause in almost half of women over 40 (48.5%). Its authors said these symptoms are often missed and left untreated in India. So the questionnaire asks about them in plain words. It's easier to tick a box than to find the words.

Question 5

What does the science say about each area?

Accepted Answer

Here's the research behind each of the 13 areas. Most of these studies were done outside India, and Indian numbers vary a lot from study to study. Every area also has an "Other" box. If something you've noticed isn't listed, it still counts.

Question 6

Why does it say many of these have other causes?

Accepted Answer

Because they do, and your doctor needs the whole list to work out which is which. Before putting symptoms down to menopause, India's guideline tells doctors to rule out low vitamin D, anaemia, thyroid problems, autoimmune conditions and osteoarthritis. Low vitamin D and anaemia are both common in India: one review found 67% of adults in India low in vitamin D. Anaemia and an underactive thyroid cause the same tiredness and brain fog as perimenopause. There's more in Thyroid or perimenopause? and in our guide to low iron and ferritin. That's why the Yellow blood panel checks for these other causes as well as your hormones. It covers your thyroid, iron, blood count, vitamin B12, vitamin D and blood sugar, and we read the results together with your symptoms. The same goes for mood. About 1 in 5 Indian women over 50 has depression. Some of that is linked to menopause, and some isn't. A 2024 review in The Lancet found that the risk of depression goes up in perimenopause for some women, not all: women who've had depression before, women with severe hot flushes or poor sleep, and women under stress from other parts of life. It warns that blaming menopause for all emotional distress can harm women. Both things are true. Perimenopause explains more than most women are told. It doesn't explain everything. Asking about all of it helps your doctor see what fits and what doesn't.

Question 7

Why ask how my day has changed, and not for a score?

Accepted Answer

Because how much a symptom gets in the way of your day helps decide whether, and how, it's treated. India's guideline says symptoms should be looked at and treated when they're frequent, don't go away, or get in the way of daily life. The Menopause Society talks about hot flushes and night sweats that are "bothersome". Neither uses a score to decide. In a study of 160 women in rural South India, women with more symptoms also said their daily lives were more affected. Scores do exist. But the makers of the best-known one, the Menopause Rating Scale, found little evidence that its scores match what a doctor finds. So the questionnaire uses everyday words. For each of your main concerns, you pick a line like "I notice it, but can continue my day" or "I sometimes change or cancel plans". Then it asks which parts of your life are affected: sleep, work, concentration, looking after others, relationships, intimacy, how you feel about yourself. One line in the questionnaire says it this way: "What's harder in an ordinary day tells your doctor more than a symptom name."

Question 8

Why does it ask when it started, how often and what time of day?

Accepted Answer

Because these details help your doctor understand the symptom, and they're hard to remember during a consult. You pick up to three main concerns, most important first. Only those get the detailed questions. When did it start? Did it start all at once, or over weeks or months? Is it happening more often? Is it worse at night? What have you tried, and did it help? If you answer at home, with a period app or a notebook open, your answers will be more accurate than if you try to remember during the call. And your doctor can go straight to what to do next.

Question 9

Why so many questions about my periods?

Accepted Answer

Because your periods are the clearest sign of where you are in the transition, and some bleeding needs to be checked. Researchers say early perimenopause starts when the length of your cycle changes by 7 days or more, and this happens again within 10 cycles. Late perimenopause starts the first time you go 60 days or more without a period. Any bleeding a year or more after your last period needs to be checked without delay. In a review of 129 studies, most women with bleeding after menopause did not have cancer, but 9% had womb cancer. For unusual bleeding in perimenopause, India's guideline recommends an ultrasound first, and a sample of the womb lining for women aged 40 and over. Our guides on heavy periods and clots and endometrial thickness explain more. The questionnaire says "a rough answer is fine". It is.

Question 10

Why ask my mother when her periods stopped?

Accepted Answer

Because your mother's age at menopause is linked to yours, and family history changes which checks you need. In India, the average age at menopause is 46.6. Your mother's age helps your doctor judge whether you're likely to be earlier or later than that. About half the difference in when women reach menopause comes from their genes. In one study, women whose mothers had an early menopause were much more likely to have an early menopause too. Only half the women in that study knew their mother's age at menopause. So ask her. A rough answer is fine. Most women remember their own age at menopause to within a year, and in another study it made no difference whether the mother or the daughter reported it. Family history also matters for other things: Blood clots. If clots run in your family, your doctor may want a blood specialist's opinion before considering hormone treatment. Bones. A parent who broke a hip raises your risk of osteoporosis. Heart. Heart disease in a close relative at a young age (before 55 in men, before 65 in women) raises your risk. Breast cancer. A mother, sister or daughter with breast cancer raises your risk. But 8 out of 9 women who get breast cancer have no mother, sister or daughter with it. So no family history doesn't mean no risk, and a family history doesn't mean you will get it. The questionnaire asks about mothers, sisters, grandmothers and aunts. You don't need to give names.

Question 11

Why list Ayurvedic products and supplements?

Accepted Answer

Because they're part of what you take, and your doctor needs to check them against anything they suggest. Britain's NICE guideline says the safety, quality and contents of unregulated products may be unknown, and that some herbal products interact with other medicines. India's guideline adds that ginseng, soy and red clover can cause vaginal bleeding. If your doctor is trying to find out why you're bleeding, they need to know this. So the questionnaire asks about all of it: prescriptions, supplements, and herbal, Ayurvedic or other products. There's no judgement in the question. The aim is a complete list.

Question 12

Why the medical history and past operations?

Accepted Answer

Because some conditions change which treatments are safe for you. For example, India's guideline says hormone therapy should be avoided in women with established heart disease, or who have had a blood clot or a stroke. It also says hormone therapy taken as tablets, patches or gels should not be used for menopausal symptoms in women who have had breast cancer. Your doctor needs to know this before talking about options with you. Operations matter too. Surgery on the womb or ovaries changes what your doctor checks for. Our guide to hysterectomy with the ovaries kept explains one common case. Pick only conditions a doctor has diagnosed. If you're not sure, choose "Unsure".

Question 13

Why pick my own questions?

Accepted Answer

Because it's easy to forget your questions once the consult starts. In the UK study I mentioned earlier, most patients left without saying everything they had come to say. People who write their questions down ask more of them. So the last part asks you to pick up to three questions, and says: "Your doctor will make sure these get answered." There's also one open box: "What's the one thing you most want your doctor to hear?" Write it the way you'd say it. A few words is enough. You can also tap the microphone on your keyboard and speak instead of typing.

Question 14

Do I have to answer everything?

Accepted Answer

No. You can skip any question. "Unsure" counts as an answer. You can save a question for later, or stop and continue another time. Your answers save as you go. Some parts only need a yes or no, and you can give the details on the call. Some parts are optional, like family history, or data from a period app or a smartwatch. Before anything is sent, you can see all your answers and change any of them. They go to Yellow only when you tick the consent box and press submit. Your doctor reads them before your first call, and your coach uses the answers about your routine to plan around your day.

Question 15

What don't we know yet?

Accepted Answer

We don't know yet if 25 minutes is the right length, or if some questions feel wrong or leave out something that matters to you. The questionnaire is new, and we'll keep changing it based on what women tell us. If a question felt wrong, or one was missing, write to me at hello@spotyellow.com. Your answers won't diagnose anything. They tell your doctor what's been happening to you before your first call.

Area	What the questionnaire asks about	What research shows
Periods and bleeding	Cycles closer together or further apart, heavier or lighter, missed months	Changes in your cycle are the main sign of which stage of perimenopause you're in. More below.
Temperature	Hot flushes, night sweats, chills after a flush	Indian studies report hot flushes in 16.5% to 88% of women, depending on the study. In a US study, half the women who had them often still had them after 7.4 years.
Sleep	Falling asleep, waking at night, waking early, feeling unrefreshed, snoring	In Indian studies, sleep problems affect 39% to 47% of women in perimenopause. Sleep is one of the two parts of life most affected.
Mood	Low mood, worry, panic, irritability, anger, feeling overwhelmed	In a US study, women with no history of depression were more likely to be diagnosed with it during the transition. This isn't true for every woman. More below.
Thinking and memory	Concentration, forgetting, finding words, making decisions	In a US study, memory test scores stopped improving with practice in perimenopause, and improved again after menopause.
Energy	Tiredness, physical and mental exhaustion, stamina	Across studies worldwide, 64% of women in midlife reported exhaustion.
Headaches and nerves	New headaches, a change in migraines, dizziness, tingling	This tells your doctor which headaches are new for you. More in our guide to hormonal headaches.
Joints, muscles and bones	Joint pain, stiffness, strength, balance, falls, a broken bone after a small fall	Joint and muscle pain is the most common midlife symptom worldwide (65%). A past broken bone raises the risk of osteoporosis.
Vaginal, urinary and pelvic	Dryness, pain, a sudden need to pee, leaks, infections that keep coming back, pelvic heaviness	Almost half of Indian women over 40 (48.5%) had these symptoms in a 2025 study. Urinary symptoms and vaginal dryness were the most common.
Sexual wellbeing	Desire, arousal, orgasm, pain, distress	Of everything vaginal and vulval symptoms affect, sex is affected the most, for 40% of women.
Heart and metabolism	Palpitations, breathlessness, weight and body shape, changes in blood pressure or sugar	In a US study, 1 in 6 women had a high chance of palpitations throughout the transition.
Skin, hair and other changes	Hair thinning, dry skin, dry eyes or mouth, breast changes, digestion	Skin loses about 2% of its collagen each year after menopause.
Teeth and gums	Sensitive teeth, sore gums	There's little research on this. India's guideline still recommends dental check-ups in midlife.

Why Yellow asks so much before your first consult