Menstruation Experience & Needs

Your feedback helps build better, more empathetic health solutions. All fields are required.

1. Basic Information

Name (or Pseudonym)*

Age range*

Location*

Occupation*

2. Menstrual Cycle Information

At what age did you get your first period?*

Under 10 10–12 13–15 16+

How regular is your cycle?*

Very regular Somewhat regular Irregular I don’t track

Average cycle length:*

< 21 days 21–28 days 29–35 days > 35 days Not sure

Duration of period:*

1–2 days 3–5 days 6–8 days > 8 days

3. Symptoms & Challenges

What symptoms do you experience? (Select all that apply)*

Cramps Headaches Back pain Mood swings Fatigue Acne Nausea Heavy bleeding Irregular bleeding

How severe are your symptoms?*

Mild Moderate Severe (affects daily life)

Do your symptoms affect: (Select all that apply)*

Work/school Sleep Social activities Mental health None of the above

4. Current Practices

What products do you use? (Select all that apply)*

Pads Tampons Menstrual cup Period underwear

Do you track your cycle?*

Yes (via App) Yes (Manually) No

Which app/tools do you use?*

5. Problems & Gaps

What are your biggest challenges during menstruation?*

What do you feel is missing in current apps or solutions?*

Have you ever avoided activities due to your period?*

Yes No

6. Health Awareness

Have you consulted a doctor about menstrual issues?*

Yes No

Are you aware of conditions like:*

PCOS (Polycystic Ovary Syndrome)

Yes No

Endometriosis

Yes No

Hormonal Imbalance

Yes No

7. App Feature Preferences

What features would you like in a menstruation app? (Select all that apply)*

Cycle tracking Symptom tracking Pain management tips Doctor consultation Community support Educational content Reminders Mood tracking AI predictions Privacy focus

What would make you trust an app with your data?*

8. Final Feedback

If you could build the perfect app, what would it do?*

Any additional comments or suggestions:*

By checking this box, I acknowledge that my data will be securely encrypted. This data is being provided exclusively to PathSutra and will be used solely for the purpose of creating a period app.