An 18-question self-assessment based on the validated Greene Climacteric Scale, the same tool clinicians use to track perimenopause and menopause symptom severity. Get your score, see which symptom domains are driving it, and learn what HRT does for someone with your profile.
In the past month, how often have you experienced sudden waves of heat?
The Greene scale ranges 0-63. Most clinicians use these bands to gauge whether HRT is appropriate.
Few or mild symptoms. HRT is generally not indicated. Worth re-checking in 12 months if you’re in your 40s.
Early perimenopausal symptoms. Lifestyle interventions first; HRT considered if symptoms are disrupting sleep or quality of life.
Significant symptom burden. HRT typically appropriate. Most patients in this band see major relief within 4-8 weeks of starting.
Severe symptom burden. Strong HRT indication. Quality of life is materially impacted; relief is usually rapid and dramatic.
The Greene scale separates symptoms into four domains because the right protocol depends on which symptoms dominate.
The textbook menopause symptoms. Driven by estradiol decline and hypothalamic thermoregulation changes. Estradiol resolves these in 4-8 weeks for 80-90% of patients at appropriate doses.
The physical symptoms that don’t look hormonal, but are. Estradiol stabilizes sleep architecture; progesterone’s GABA-active metabolite handles sleep onset. Joint stiffness often resolves with estradiol restoration.
The flatness, irritability, and cognitive slip that get misattributed to aging. Estradiol withdrawal, not aging. Patients in the 10-year “window of opportunity” see the strongest cognitive recovery.
Urogenital atrophy from estrogen withdrawal. Topical estradiol cream resolves these locally with minimal systemic absorption. A different intervention than systemic HRT, sometimes used alongside.
The Greene Climacteric Scale (Greene, 1998) is a 21-item validated self-report instrument used in clinical research and practice to measure climacteric symptoms in women. It’s the most widely cited symptom inventory in modern menopause medicine.
This tool uses 18 of the 21 Greene items, scored on the standard 0-3 Likert (none / mild / moderate / severe). Maximum possible score is 54 (instead of 63 in the full scale) because we’ve trimmed three less-actionable items, but the tier interpretation remains aligned with published clinical thresholds.
Two things:
Bioidentical estradiol and progesterone, prescribed online by U.S. licensed physicians, calibrated to your numbers. The HRT bundle starts at $199/mo, consult, medication, and ongoing monitoring included.
Explore OPTML HRT →How this tool calculates
The symptom score uses the validated Greene Climacteric Scale, a 21-item instrument that assesses psychological, somatic, vasomotor, and sexual symptoms commonly associated with the menopausal transition. The tool is educational and is intended to support a conversation with a clinician — it does not diagnose perimenopause.
Peer-reviewed sources
Important. This tool is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment. The tool does not prescribe medication, recommend specific dosing, or substitute for clinical evaluation. Compounded medications referenced anywhere on this site are not FDA-approved; the FDA does not verify the safety, effectiveness, or quality of compounded drugs. Treatment decisions are made only by a licensed U.S. physician after individual patient evaluation.