Participant ID #

The next questions are about your feelings during the past 4 weeks. For each of the statements, please indicate the choice that tells how often you felt that way.

Rarely or none of the time (less than 1 day)

Some or a little of the time (1-2 days)

Occasionally or a moderate amount of time (3-4 days)

Most or all of the time (5-7 days)

Not Answered

100.1 You felt depressed (blue or down)
100.2 Your sleep was restless
100.3 You enjoyed life
100.4 You had crying spells
100.5 You felt sad
100.6 You felt that people disliked you

101. In the past year, have you had two weeks or more during which you felt sad, blue, or depressed, or lost pleasure in things that you usually care about or enjoyed?
	No Yes Not answered

102. Have you had two years or more in your life when you felt depressed or sad most days, even if you felt okay sometimes?
	No (skip to question 103) Yes Not answered

	102.1 Have you felt depressed or sad much of the time in the past year?	No     Yes     Not answered

These next questions are about your sleep habits. Please mark one of the answers for each of the following questions. Pick the answer that best describes how often you experienced the situation in the past 4 weeks.

103. Did you take any kind of medication or alcohol at bedtime to help you sleep?	Choose OneNo, not at allYes, less than once a weekYes, 1-2 times a weekYes, 3-4 times a weekYes, 5 or more times a week
104. Did you fall asleep during quiet activities like reading, watching TV, or riding in a car?	Choose OneNo, not at allYes, less than once a weekYes, 1-2 times a weekYes, 3-4 times a weekYes, 5 or more times a week
105. Did you nap during the day?	Choose OneNo, not at allYes, less than once a weekYes, 1-2 times a weekYes, 3-4 times a weekYes, 5 or more times a week
106. Did you have trouble falling asleep?	Choose OneNo, not at allYes, less than once a weekYes, 1-2 times a weekYes, 3-4 times a weekYes, 5 or more times a week
107. Did you wake up several times at night?	Choose OneNo, not at allYes, less than once a weekYes, 1-2 times a weekYes, 3-4 times a weekYes, 5 or more times a week
108. Did you wake up earlier than you planned to?	Choose OneNo, not at allYes, less than once a weekYes, 1-2 times a weekYes, 3-4 times a weekYes, 5 or more times a week
109. Did you have trouble getting back to sleep after you woke up too early?	Choose OneNo, not at allYes, less than once a weekYes, 1-2 times a weekYes, 3-4 times a weekYes, 5 or more times a week
110. Did you snore?	Choose OneNo, not at allYes, less than once a weekYes, 1-2 times a weekYes, 3-4 times a weekYes, 5 or more times a weekDon't know

111. Overall, was your typical night's sleep during the past 4 weeks:

Very sound or restful

Sound or restful

Average quality

Restless

Very restless

Not answered

112. About how many hours of sleep did you get on a typical night during the past 4 weeks?

Number Of Hours Per Night
<5	6	7	8	9	10+	Not Answered

Many women report that they leak urine (or pee). The next questions are about problems you may have had with leaking urine.

113. Have you ever leaked even a very small amount of urine involuntarily and you couldn't control it?
	Yes No (Skip to Question 120) Not answered
114. How often does this leaking urine occur?
	Not once during the past year Less than once a month More than once a month but less than once a week One or more times a week but less than every day Daily Not answered
115. When do you usually leak urine?
	No longer leak urine (Skip to Question 120) When I cough, laugh, sneeze, lift, stand up, or exercise When I feel the need to urinate and can't get to a toilet fast enough When I am sleeping Other (describe): Not answered
116. How much urine do you usually lose when it leaks?
	None Barely noticeable on underpants Soaked underpants Soaked through to outer clothing Not answered
117. What protection do you wear in case you leak urine?
	None Mini-pad, tissue or paper towel Menstrual pad or shield Diaper, towel, Attends, Depends Other Not answered
118. How often does the leakage or urine limit your daily activities?
	Never Almost never Sometimes Fairly often Very often Not answered
119. How much does the leakage of urine bother or disturb you?
	None A little disturbing Somewhat disturbing Very disturbing Extremely disturbing Not answered

These questions ask about some personal topics. Although the following questions are sensitive and personal, they are important. Your answers will help us understand the health of women and may help us find better treatments for their health problems. Please be assured that your responses to these questions will remain confidential.

120. Are you currently married or in an intimate relationship with at least one person?
	Yes No Not answered
121. Did you have any sexual activity with a partner in the last year?
	Yes No Not answered
122. How satisfied are you with your current sexual activities, either with a partner or alone?
	Very unsatisfied A little unsatisfied Somewhat satisfied Very satisfied Prefer not to answer
123. How satisfied are you with the frequency of your sexual activity, or would you like to have sex more or less often?
	Less often With current frequency More often Prefer not to answer
124. Are you worried that sexual activities will affect your health?
	Not at all worried A little worried Somewhat worried Very worried Prefer not to answer
125. Regardless of whether you are currently sexually active, which response best describes who you have had sex with over your adult lifetime?
	Have never had sex Sex with a woman or with women Sex with a man or with men Sex with both men and women Prefer not to answer
126. Which response best describes who you have had sex with in the past 10 years?
	Never had sex Sex with a woman or with women Sex with a man or with men Sex with both men and women Prefer not to answer