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Vaginal Rejuvenation
Assessment
Vaginal Rejuvenation Assessment
1.
Do you have vaginal looseness or laxity?
Yes
Not Sure
No
1 out of 10
2.
How often do you experience pain with sex?
Often
Sometimes
Never
2 out of 10
3.
Do you have vaginal dryness?
Yes
Not Sure
No
3 out of 10
4.
Have you experienced a recent loss of sexual enjoyment?
Yes
Not Sure
No
4 out of 10
5.
Have you experienced a decrease in your ability to achieve orgasm?
Yes
Not Sure
No
5 out of 10
6.
Have you recently experienced vaginal itching or vaginal discharge?
Yes
Not Sure
No
6 out of 10
7.
Have you recently experienced bladder incontinence?
Yes
Not Sure
No
7 out of 10
8.
How often do you need to get up at night to urinate?
Often
Sometimes
Never
8 out of 10
9.
Have you recently experienced vulvar or labial itching?
Yes
Not Sure
No
9 out of 10
10.
Have you recently experienced urine urgency or increased frequency?
Yes
Not Sure
No
10 out of 10
Time is Up!
Time's up
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