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Patient ID: Sex: Age: Nature of work: Habits:


Please answer the following questions in a descriptive manner after careful analysis and recollection of previous experience and happenings.

1. Describe your main suffering? State the correct location of pain or suffering.

2. What other physical sufferings do you have in your body?

3. What mental sufferings / feelings do you have associated with your physical sufferings?

4. What exactly do you feel when you are at your worst? Describe the sensation in your own words.

5. When did it all start? Can you connect it to any past event or disease? What was happening in your life just before these symptoms were noticed?

6. What time of the day do you suffer the most? What time of the day /night do you feel most energetic and happy?

7. What are the things that aggravate your suffering and those that ameliorate the same? Example: time, hot or cold application, pressure, rubbing, washing, eating, tight clothing, sweating, walking, climbing, stool etc.

8. Do you think your sufferings have direct relation to any particular external factor or are it something to do with your own biological changes?
9. When do you feel better, during hot weather or cold weather, humid or dry weather?

10. Describe your general mental set up? Please pick out the adjectives which best describe your personality; (at least 10)
Nervous, Anxious, Shy, Worrying, Paranoid, Proud, Unsocial, Guilty, Depressed, Hypochondriac, Untidy, Weepy, Emotional, Impractical, Confused, Suspicious, Jealous, Timid, Aggressive, Headstrong, Forgetful, Follower, Insecure, Immature, Impulsive, Rigid, Restless, Feminine, Empathetic, Introverted.

- How do you feel before or during a thunderstorm?

- How do you respond to consolation during your tough times?

- Are you sensitive to external stimuli like smell, noise, light etc.?

- Do you have any typical habit or gesture like nail biting, causeless
Weeping, talking to one self etc?
- How do you get along with your friends, family, your children and especially your husband / wife?
-What is your profession? Do you love your profession? What is your dream job?
-Did you have any bereavement in life? How has it affected you?
-Do you have any issues regarding your parenting by guardians?
-Can you remember any unfortunate incident in life that you want to forget?
-How do you respond to music? Do you feel better or worse mentally listening to music?
- What upsets you most in yourself and in others?

11. What are your fears and do you dream of any situation repeatedly?

12. What do you crave in food items and what are your aversions?

13. How is your thirst: Less, Normal or Excessive?

14. How is your hunger: Less, Normal or Excessive?

15. Is there any kind of food which your body can’t stand?

16. Is your sweat normal or less or more? Where does it sweat more: Head, Trunk or Limbs?

17. How is your bowel movement and stool type? Do you have any abnormal smell in the urine?

18. How well do you sleep? Do you have a particular posture of sleeping?

19. Do you think you are able to address your libido in general? Would you say your drive is low, normal or high?

20. Do you have any strange, peculiar or unusual sensation, thoughts or feelings? How are you different from others?

21. What medications have been taken earlier by you to treat the diseases and do you have any particular symptom surfacing after the medication?

22. What major diseases have run in the family in the last two generations both sides?

23. Describe your overall appearance with respect to your BMI, skin type, muscular or flabby etc.
24. What major diseases have you had in your life and when. Please write them in a chronological manner.
(For Females)
25. If your menstrual cycles are not normal, please describe all irregularities, like pains, moods, flow type, clots etc. as below:
- Are your periods generally regular, early or delayed? What is the usual cycle duration?
- Describe the sensations and locations of pain before, during and after the flow.
- How do you generally deal with your sufferings during periods? Do you have any non-medical way of relieving your suffering?
- What is the duration of flow? Is it heavy, medium or light?
- Do you observe clots?
- Do you have mid-cycle spotting? What are the days you have spotting?
- Describe changes in your mental condition or any other peculiar symptom that surfaces before, during or after the flow.
- Do your sufferings increase or decrease as soon as the flow begins?
- Did you ever take birth control pills on a regular basis?
- Have you ever been treated earlier or recently for any gynecological irregularity? Please describe.

Please describe your sufferings by answering these questions.

You shouldn't tell him anything about your earlier partnerships and likewise you shouldn't ask as well. This is the safest bet.

There is no problem if you don't bleed as there are many other ways in which a women's hymen can be ruptured. So, nobody would ever be able to prove anything.

The call is yours if you would disclose or hide. Do what is good for the marriage.

Its pointless to feel bad about it now. You could have ruptured your hymen either by cycling, running or any other form of athletics.

Even if you say you are a virgin, for the sake of your marriage, he won't be able to prove otherwise.

You can do 'Kegel Excercises' to tome up your muscles. You can do this at home.

Google up and get more info how to do them.

Go for Youtube demonstrations.

Unfortunately, there is no other easy way. If you do the exercises that make your pelvic muscles strong, as demonstrated in some of youtube presentations, it will help you.

https://www.youtube.com/watch?v=wRKhtfbJHdo

Look up the above link and do it once a day.