Coastal Goddess Intimate Health Month Survey

Intimate Health Questionnaire

During Coastal Goddess' Intimate Health Month, we are wanting to know more about the intimate health and wellbeing of our community. If you would like to go in the draw to win a $200 Coastal Goddess Gift Voucher, please fill out the question to the anonymous survey below and leave your email address in the final question.

This information will not be used for individual's information and used only for aggregate data to help inform our understand of our communities intimate health. Your data and sensitive information will not shared outside of this survey. The only personal information that will be used is your contact details if you wish to enter the draw to win our competition.
1.How old are you?
2.Where in the"body lifecycle" would you say you belong?
3.How many births have you experienced?
4.Have you heard of Vaginal Relaxation Syndrome?
5.How would you describe your vaginal laxity?
6.Do you wet your pants occassionally?
7.Do you feel the need to cross your legs when you sneeze
8.Is pigmentation in the vuval region a concern for you?
9.Have changes in your vagina affected your libido?
10.Do you experience vaginal dryness, itching or burning?
11.Is there any pain or discomfort during sexual intercourse (dyspareunia)?
12.Have you noticed any changes in your vaginal discharge?
13.Have you ever experienced any hot flashes, night sweats, or other menopausal symptoms?
14.Are you currently taking any hormone replacement therapy (HRT)?
15.Have you made any recent changes to your diet or exercise routine?
16.What is your daily fluid intake like? Do you drink plenty of water?
17.Do you feel comfortable discussing your symptoms with your partner or loved ones?
18.Have you tried any treatments for your symptoms, such as over-the-counter lubricants or moisturizers?
19.Do you have any other medical conditions that might affect your vaginal health, such as diabetes or autoimmune disorders or cancer?
20.Do you have any history of gynecological conditions, such as endometriosis or fibroids?
21.Would you like to book an appointment with Dr Kelly to further evaluate your symptoms?
22.Would you like to go in the draw to win a Coastal Goddess Gift Voucher valued at $200?
Current Progress,
0 of 22 answered