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Endometriosis
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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1
Who has been diagnosed with endometriosis?
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Me
Another person close to me
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2
How long did it take to get diagnosed?
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a few months
1-3 years
3-6 years
6-10 years
over 10 years
I dont know
No diagnosis yet, but endometriosis is suspected
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3
Were you and your complaints noticed by doctors and those around you (and not simply brushed aside?)
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yes
rather yes
rather no
no/definitely not
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4
Are/have you taken hormonal medication for endometriosis?
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Yes, I took them but stopped
Yes, I am currently taking them
No, I have never taken any
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5
What hormonal preparations do you use/have you used?
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6
How much did the hormones relieve your symptoms?
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very much
a little bit
barely
not at all
symptoms have worsened
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7
Have you had any side effects when taking hormonal preparations? If so, which ones?
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8
Are there any other experiences in dealing with endometriosis that you would like to share with me? (every little bit helps me a lot)
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9
Do you think hormonal treatments should continue to be the first treatment option for endometriosis? Why/why not?
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10
How old are you?
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under 18
18-25
25-35
35-45
45-55
over 55
I dont want to say
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11
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