Greene Climacteric Scale: the online test
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.
Medically reviewed by Dr. William Declerck, physician
Reviewed on . 7-minute read.
It takes about 5 minutes, and your results are sent to your email.
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.
Greene Climacteric Scale
What your score means
Each of Greene's 21 questions scores 0 (not at all) to 3 (extremely). Added up, that gives a total between 0 and 63: the higher your total, the more your symptoms weigh on you. Uma adds 4 questions on bladder and vagina; how these count in your result is still to be confirmed.
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?
Check for yourself
How did you score?
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 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 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.
Choose the answer that fits your result.
What is the Greene Climacteric Scale, and why is it used?
The Greene Climacteric Scale was developed by British researcher J.G. Greene1 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 31:
- 0: Not at all (the symptom is absent)
- 1: A little (occasional, not disruptive)
- 2: Quite a bit (frequent, disruptive to activities)
- 3: Extremely (very frequent, activities must be interrupted)
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
11 questions
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.
Vasomotor symptoms
2 questions
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.
Vulvovaginal symptoms
4 questions, added by Uma
Vaginal dryness, irritation, itching, recurrent infections, changes in bladder or urinary function. These symptoms are closely linked to declining oestrogen.2,4 They are among the most underdiagnosed aspects of perimenopause, and among the most kept silent.2,3
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.
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.1,4 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.5
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. And if you're already in treatment, it gives you a way to track how your symptoms change over time.
Sources (5)
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.
- Faubion, S.S., Sood, R. & Kapoor, E. (2017). Genitourinary syndrome of menopause: management strategies for the clinician. Mayo Clinic Proceedings, 92(12), 1842–1849.
- 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.
- Rozenberg, S. et al. (2026). Guidelines Menopause. Belgian Menopause Society.
- National Institute for Health and Care Excellence (2015, updated 2026). Menopause: identification and management. NICE Guideline NG23.
The content of this page is intended as information and does not replace medical advice. Consult a doctor for a personal assessment.
Frequently asked questions
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.
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!
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.
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.
Talk it through with someone who knows perimenopause
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.