Does the GCS provide a diagnosis?

No, and that's important to know before you start. The GCS maps your symptom pattern. A doctor uses your score together with your full symptom history to reach an assessment. The questionnaire is a starting point, not a final verdict.

Can I fill in this questionnaire if my periods are still regular?

Yes. This is one of the most common misunderstandings about perimenopause. Hormonal fluctuations often start years before anything changes in the cycle — and so do the associated symptoms. That's why the GCS doesn't ask about your menstruation. This is intentional!

What's the difference with a blood test?

If you've had a blood test and were told everything was normal, that's frustrating but not surprising. During perimenopause, hormone levels fluctuate constantly. A single measurement says little about how you feel day-to-day. The GCS maps your symptom pattern over time.

The Greene Climacteric Scale

How do you know if your symptoms are part of perimenopause?

Q: What if my GCS score is low but I still don't feel well?

Trust that feeling. A low score with persistent symptoms is still a reason to start a conversation with a healthcare provider specialised in perimenopause. A questionnaire has its limits. Your experience does not.

What you'll find on this page

Perhaps you've been wondering for a while whether what you're feeling has anything to do with perimenopause. Perhaps a doctor has already examined you and found nothing. In both cases, the Greene Climacteric Scale (GCS) can help.

On this page we explain what the GCS is, what it measures, and what your score means. At the bottom you'll find the questionnaire itself. Filling it in takes five minutes. Your results are sent to your email address so you can keep them or bring them to a consultation.

The GCS does not provide a diagnosis. It's a way to structure what you're experiencing, both for yourself and for a healthcare provider.

Fill in the questionnaire

In short

The Greene Climacteric Scale (GCS) is an internationally recognised questionnaire used by doctors and menopause consultants worldwide to map perimenopausal symptoms.
The standard GCS asks 21 questions across four domains: psychological symptoms, somatic symptoms, vasomotor symptoms, and sexual function.
The adapted version you can complete on this page adds a fifth domain: vulvovaginal symptoms. These are symptoms often (but not always) closely linked to declining oestrogen, yet rarely discussed.
A score above 12 typically indicates a significant symptom burden where specialist advice is worthwhile.
The GCS does not provide a diagnosis. It gives structure to the conversation with a healthcare provider.
You can fill in the adapted GCS below. Your results will be sent to your email address.

Frequently asked questions

What does perimenopause look like in practice?

Perimenopause is the transitional period before menopause. It typically starts in the early to mid-forties, sometimes as early as 35. The ovaries begin to produce less oestrogen and progesterone. This process is gradual and uneven.

What surprises many women: menstruation can still be entirely normal. There's no starting gun, no clear moment at which perimenopause begins. That makes it hard to recognise — for women themselves and for doctors.

Mood swings, sleep problems, joint pain, palpitations, concentration issues. The symptom pattern is broad and overlaps strongly with stress and burnout. Women who consult their GP are told their blood values are normal. That's true. But it doesn't tell the full story.

The GCS is valuable at three moments. If you're just beginning to wonder whether what you're feeling has anything to do with perimenopause, it helps you structure your symptoms. If you've already seen a doctor without a clear outcome, it helps make the conversation more concrete at the next consultation.

What is the Greene Climacteric Scale, and why is it used?

The Greene Climacteric Scale was developed by British researcher J.G. Greene and is used worldwide by doctors and menopause consultants. It is used in clinical research on perimenopause and in preparation for consultations.

The questionnaire asks 21 questions. For each one, you indicate how much you experience a particular symptom, on a scale of 0 to 3:

0: absent
1: occasionally, not bothersome
2: often, bothersome
3: very often, activities are interrupted by it

What the GCS does: it gives language to symptoms you may have struggled to articulate, and provides a starting point for the conversation with a healthcare provider.

What does the GCS measure?

The questionnaire covers five domains. Some are familiar. Others come as a surprise.

Psychological symptoms

Irritability that seems to come from nowhere. A shorter fuse. A sense of worry about everyday things that doesn't quite fit who you are. A low mood that isn't exactly depression, but isn't nothing either. These symptoms are rarely linked to hormones straight away, and that's exactly why they go unnamed for so long.

Somatic symptoms

Joint pain, headaches, palpitations, dizziness, tingling in hands or feet. These are the symptoms that most often lead to unnecessary medical investigations, because they're not associated with hormonal fluctuations. But they certainly belong to the picture.

Vasomotor symptoms

Hot flushes and night sweats. The most well-known symptoms, but they often don't appear in early perimenopause. No hot flushes does not mean you don't have perimenopause.

Sexual function

Changes in libido, less arousal, discomfort during sex. Common and treatable. They are rarely brought up spontaneously in a standard GP appointment. The GCS names them, so you can name them too.

Vulvovaginal symptoms

Vaginal dryness, irritation, itching, recurrent infections, changes in bladder or urinary function. These symptoms are closely linked to declining oestrogen. They are among the most underdiagnosed aspects of perimenopause — and among the most kept silent.

Many women carry these symptoms for years. Not because they aren't bothered, but because they didn't know they belonged to the picture, or didn't know how to bring them up. Dr. William Declerck, doctor and co-founder of Uma, includes this domain as standard in his assessment. Otherwise it disappears too easily from view — and stays untreated.

The GCS does not provide a diagnosis and does not replace medical advice. It gives you an overview of what you're experiencing. That's the starting point.

Fill in the adapted GCS questionnaire

The quiz below is based on the Greene Climacteric Scale, supplemented with the vulvovaginal domain. Filling it in takes about five minutes on average. Your results are sent to your email address so you can keep them or bring them to a consultation. If you have an Uma account, you'll also find them there.

A completed questionnaire is not a diagnosis. What it is: a concrete starting point for a conversation that would otherwise be hard to begin.

Green Climateric Scale

What your score means

Suppose you score 15. That means you regularly experience symptoms across several domains that affect your daily functioning. That's not something to brush aside. It's also no reason to panic. It's information.

A score above 12 on the full GCS is associated in research with a significant symptom burden. Women in this range usually benefit from a conversation with a healthcare provider specialised in perimenopause — someone who takes the time to look at the full clinical picture.

What the score does most: it gives structure. You no longer walk into a consultation with a vague feeling that's hard to describe. You have an overview. That makes the conversation more concrete for you and for the healthcare provider.

What now?

Your score is low, but you still don't feel well

If your symptoms persist but your score is low, that says something about the limits of a questionnaire, not about the validity of what you're experiencing. It may still be perimenopause, or it may be something underlying. Either way, it can be worth speaking with a healthcare provider who looks at your situation through the lens of perimenopause.

Your score is moderate

Your symptoms are present and affect your daily life. That's worth discussing concretely. Take your results to a doctor and ask for a full conversation about your symptom picture.

Your score is high

Your symptoms are significantly present across multiple domains. You don't have to keep carrying this alone. Take your results to a doctor familiar with perimenopause. You don't have to start the conversation from scratch — you now have a concrete overview.

Don't yet have a doctor or healthcare provider you can discuss this with? Through Uma you can find providers with specific expertise in perimenopause. An intake consultation takes about 30 minutes on average, and you leave with a plan.

The information on this page is based on peer-reviewed scientific literature and recognised clinical guidelines. The clinical interpretations were reviewed by Dr. William Declerck, MD.

Greene, J.G. (1998). Constructing a standard climacteric scale. Maturitas, 29(1), 25–31. https://pubmed.ncbi.nlm.nih.gov/9643514/
National Institute for Health and Care Excellence. (2015, updated 2026). Menopause: identification and management (Guideline NG23). https://www.nice.org.uk/guidance/ng23
Rozenberg, S. & Belgian Menopause Society. (2026). Menopause Guidelines. Belgian Menopause Society. https://www.menopausesociety.be/wp-content/uploads/2026/01/Richtlijnen-Menopauze_WL_A6_NL_ZONDERPAS.pdf
Faubion, S.S. et al. (2017). Genitourinary syndrome of menopause: management strategies for the clinician. Mayo Clinic Proceedings, 92(12), 1842–1849. https://pubmed.ncbi.nlm.nih.gov/29202940/
Gandhi, J. et al. (2016). Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. American Journal of Obstetrics & Gynecology, 215(6), 704–711. https://www.ajog.org/article/S0002-9378(16)30518-X/fulltext

The content of this page is intended as information and does not replace medical advice. Consult a doctor for a personal assessment.