Age Range Under 40 40-50 51-60 Over 60 None Menopausal Status Pre-menopausal Peri-menopausal Post-menopausal Not sure None Frequency of UTIs in the Last Year None 1-2 times 3-4 times More than 4 times None Symptoms of Menopause None Mild Moderate Severe None Vaginal Dryness or Irritation Never Occasionally Frequently Always None Use of Hormone Replacement Therapy (HRT) Yes, currently using Used in the past Never used Considering it None Urinary Symptoms (e.g., urgency, frequency, burning) Never Occasionally Frequently Always None Previous History of UTIs before Menopause Never Rarely Occasionally Frequently None Hydration Habits Drink plenty of water daily Drink an adequate amount of water Often forget to drink water Rarely drink water None Consultation with a Healthcare Provider about UTIs and Menopause Yes, regularly Occasionally Rarely Never None 1 out of 2 Name Email Phone Time's up
