{"id":20,"date":"2016-11-17T12:49:55","date_gmt":"2016-11-17T11:49:55","guid":{"rendered":"http:\/\/menopearl\/?page_id=20"},"modified":"2020-09-09T19:50:07","modified_gmt":"2020-09-09T17:50:07","slug":"selbsttest","status":"publish","type":"page","link":"https:\/\/menopearl.com\/de\/meine-menopause\/selbsttest\/","title":{"rendered":"Selbsttest"},"content":{"rendered":"\n<div class=\"wp-block-cover alignfull is-position-center-center menopearl-page-header\" style=\"background-image:url(https:\/\/menopearl.com\/wp-content\/uploads\/2020\/09\/page-header-bg-scaled.jpg);background-position:50% 50%\"><div class=\"wp-block-cover__inner-container is-layout-flow wp-block-cover-is-layout-flow\">\n<p class=\"has-text-align-center has-white-color has-text-color\">\u00abMIR IST HESS UND MIR IST KALT. <br><strong>LIEGT DAS NUR AM WETTER?<\/strong>\u00bb<\/p>\n\n\n\n<div class=\"wp-block-image show-for-medium\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/menopearl.com\/wp-content\/uploads\/2020\/08\/pearl.png\" alt=\"\" class=\"wp-image-1496\" width=\"72\" height=\"72\" srcset=\"https:\/\/menopearl.com\/wp-content\/uploads\/2020\/08\/pearl.png 288w, https:\/\/menopearl.com\/wp-content\/uploads\/2020\/08\/pearl-150x150.png 150w, https:\/\/menopearl.com\/wp-content\/uploads\/2020\/08\/pearl-125x125.png 125w\" sizes=\"auto, (max-width: 72px) 100vw, 72px\" \/><\/figure><\/div>\n<\/div><\/div>\n\n\n\n<h1 class=\"has-text-align-center has-purple-color has-text-color wp-block-heading\">SELBSTTEST<\/h1>\n\n\n\n<p class=\"has-purple-color has-text-color\"><strong>Haben Sie schon das eine oder andere Symptom bei sich bemerkt? Mit diesem einfachen Test k\u00f6nnen Sie schnell herausfinden, ob der Wechsel bei Ihnen schon begonnen hat, oder ob Sie wom\u00f6glich kurz vor der \u2013 v\u00f6llig nat\u00fcrlichen \u2013 hormonellen Ver\u00e4nderung Ihres K\u00f6rpers stehen.<\/strong><\/p>\n\n\n\n<p>F\u00fcllen Sie daf\u00fcr einfach alle nachfolgenden Fragen aus. Nach dem Klick auf &#8222;Test auswerten&#8220; erhalten Sie sofort Ihr Ergebnis. Der Test ist&nbsp;anonym. Bitte besprechen Sie die Ergebnisse mit Ihrem behandelnden Arzt.<\/p>\n\n\n\n<div class=\"text-center\">\n<button class=\"button hollow uppercase\" data-open=\"self-test\" aria-controls=\"self-test\" aria-haspopup=\"true\" tabindex=\"0\">Test starten<\/button>\n<\/div>\n\n\n\n<div class=\"reveal\" id=\"self-test\" data-reveal=\"\" data-close-on-click=\"false\" data-reset-on-close=\"true\">\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework mrs-survey_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_14' ><style>#gform_wrapper_14 p.gform_required_legend{ display: none !important; }<\/style><div id='gf_14' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\u201e<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u201c zeigt erforderliche Felder an<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_14' id='gform_14' class='mrs-survey' action='\/de\/wp-json\/wp\/v2\/pages\/20#gf_14' data-formid='14' novalidate>\n        <div id='gf_progressbar_wrapper_14' class='gf_progressbar_wrapper' data-start-at-zero='1'>\n        \t<p class=\"gf_progressbar_title\">Schritt <span class='gf_step_current_page'>1<\/span> von <span class='gf_step_page_count'>11<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_custom' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_custom percentbar_0' style='width:0%; color:#ffffff; background-color:#DCA867;'><span>0%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_14_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_14' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_23\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"text-center text-bold\">Welche der folgenden Beschwerden haben Sie zurzeit?<\/h2>\n<p class=\"text-center\">W\u00e4hlen Sie bitte bei jeder Beschwerde, wie stark Sie davon betroffen sind. \nWenn Sie eine Beschwerde nicht haben, w\u00e4hlen Sie bitte <strong>\u00abkeine\u00bb<\/strong>.<\/p><\/div><div id=\"field_14_1\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Wallungen, Schwitzen<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_1'>(aufsteigende Hitze, Schwei\u00dfausbr\u00fcche)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='Wallungen, Schwitzen' class='gsurvey-likert' id='input_14_1'><thead><tr><th id='likert_col_1_14_1' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_1' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_1' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_1' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_1' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_1' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_1_1'    aria-labelledby='likert_col_1_14_1'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_1' type='radio' value='glikertcol1107b1565'  id='choice_14_1_2'    aria-labelledby='likert_col_2_14_1'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_1' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_1_3'    aria-labelledby='likert_col_3_14_1'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_1' type='radio' value='glikertcol1d2250c19'  id='choice_14_1_4'    aria-labelledby='likert_col_4_14_1'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_1' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_1_5'    aria-labelledby='likert_col_5_14_1'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_14_12' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_2' class='gform_page' data-js='page-field-id-12' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_2\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Herzbeschwerden<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_2'>(Herzklopfen, Herzrasen, Herzstolpern, \nHerzbeklemmungen)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='Herzbeschwerden' class='gsurvey-likert' id='input_14_2'><thead><tr><th id='likert_col_1_14_2' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_2' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_2' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_2' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_2' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_2_1'    aria-labelledby='likert_col_1_14_2'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol1107b1565'  id='choice_14_2_2'    aria-labelledby='likert_col_2_14_2'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_2_3'    aria-labelledby='likert_col_3_14_2'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol1d2250c19'  id='choice_14_2_4'    aria-labelledby='likert_col_4_14_2'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_2' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_2_5'    aria-labelledby='likert_col_5_14_2'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_14_13' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zur\u00fcck'  \/> <input type='button' id='gform_next_button_14_13' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_3' class='gform_page' data-js='page-field-id-13' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_3' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_3\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Schlafst\u00f6rungen<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_3'>(Einschlafst\u00f6rungen, Durchschlafst\u00f6rungen, zu fr\u00fches Aufwachen)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='Schlafst\u00f6rungen' class='gsurvey-likert' id='input_14_3'><thead><tr><th id='likert_col_1_14_3' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_3' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_3' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_3' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_3' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_3' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_3_1'    aria-labelledby='likert_col_1_14_3'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_3' type='radio' value='glikertcol1107b1565'  id='choice_14_3_2'    aria-labelledby='likert_col_2_14_3'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_3' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_3_3'    aria-labelledby='likert_col_3_14_3'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_3' type='radio' value='glikertcol1d2250c19'  id='choice_14_3_4'    aria-labelledby='likert_col_4_14_3'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_3' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_3_5'    aria-labelledby='likert_col_5_14_3'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_14_14' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zur\u00fcck'  \/> <input type='button' id='gform_next_button_14_14' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_4' class='gform_page' data-js='page-field-id-14' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_4' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_4\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Depressive Verstimmung<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_4'>(Mutlosigkeit, Traurigkeit, Weinerlichkeit, Antriebslosigkeit, Stimmungsschwankungen)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='Depressive Verstimmung' class='gsurvey-likert' id='input_14_4'><thead><tr><th id='likert_col_1_14_4' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_4' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_4' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_4' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_4' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_4_1'    aria-labelledby='likert_col_1_14_4'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol1107b1565'  id='choice_14_4_2'    aria-labelledby='likert_col_2_14_4'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_4_3'    aria-labelledby='likert_col_3_14_4'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol1d2250c19'  id='choice_14_4_4'    aria-labelledby='likert_col_4_14_4'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_4' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_4_5'    aria-labelledby='likert_col_5_14_4'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_14_15' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zur\u00fcck'  \/> <input type='button' id='gform_next_button_14_15' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_5' class='gform_page' data-js='page-field-id-15' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_5' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_5\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Reizbarkeit<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_5'>(Nervosit\u00e4t, innere Anspannung, Aggressivit\u00e4t)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='Reizbarkeit' class='gsurvey-likert' id='input_14_5'><thead><tr><th id='likert_col_1_14_5' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_5' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_5' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_5' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_5' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_5_1'    aria-labelledby='likert_col_1_14_5'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol1107b1565'  id='choice_14_5_2'    aria-labelledby='likert_col_2_14_5'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_5_3'    aria-labelledby='likert_col_3_14_5'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol1d2250c19'  id='choice_14_5_4'    aria-labelledby='likert_col_4_14_5'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_5' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_5_5'    aria-labelledby='likert_col_5_14_5'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_14_16' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zur\u00fcck'  \/> <input type='button' id='gform_next_button_14_16' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_6' class='gform_page' data-js='page-field-id-16' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_6' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_6\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >\u00c4ngstlichkeit<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_6'>(innere Unruhe, Panik)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='\u00c4ngstlichkeit' class='gsurvey-likert' id='input_14_6'><thead><tr><th id='likert_col_1_14_6' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_6' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_6' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_6' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_6' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_6_1'    aria-labelledby='likert_col_1_14_6'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol1107b1565'  id='choice_14_6_2'    aria-labelledby='likert_col_2_14_6'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_6_3'    aria-labelledby='likert_col_3_14_6'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol1d2250c19'  id='choice_14_6_4'    aria-labelledby='likert_col_4_14_6'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_6' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_6_5'    aria-labelledby='likert_col_5_14_6'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_14_17' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zur\u00fcck'  \/> <input type='button' id='gform_next_button_14_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_7' class='gform_page' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_7' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_7\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >K\u00f6rperliche und geistige Ersch\u00f6pfung<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_7'>(allgemeine Leistungsminderung, Ged\u00e4chtnisminderung, Konzentrationsschw\u00e4che, Vergesslichkeit)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='K\u00f6rperliche und geistige Ersch\u00f6pfung' class='gsurvey-likert' id='input_14_7'><thead><tr><th id='likert_col_1_14_7' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_7' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_7' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_7' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_7' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_7_1'    aria-labelledby='likert_col_1_14_7'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol1107b1565'  id='choice_14_7_2'    aria-labelledby='likert_col_2_14_7'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_7_3'    aria-labelledby='likert_col_3_14_7'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol1d2250c19'  id='choice_14_7_4'    aria-labelledby='likert_col_4_14_7'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_7' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_7_5'    aria-labelledby='likert_col_5_14_7'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_14_18' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zur\u00fcck'  \/> <input type='button' id='gform_next_button_14_18' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_8' class='gform_page' data-js='page-field-id-18' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_8' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_8\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Sexualprobleme<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_8'>(Ver\u00e4nderung des sexuellen Verlangens, der sexuellen Bet\u00e4tigung und Befriedigung)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='Sexualprobleme' class='gsurvey-likert' id='input_14_8'><thead><tr><th id='likert_col_1_14_8' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_8' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_8' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_8' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_8' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_8' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_8_1'    aria-labelledby='likert_col_1_14_8'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_8' type='radio' value='glikertcol1107b1565'  id='choice_14_8_2'    aria-labelledby='likert_col_2_14_8'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_8' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_8_3'    aria-labelledby='likert_col_3_14_8'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_8' type='radio' value='glikertcol1d2250c19'  id='choice_14_8_4'    aria-labelledby='likert_col_4_14_8'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_8' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_8_5'    aria-labelledby='likert_col_5_14_8'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_14_19' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zur\u00fcck'  \/> <input type='button' id='gform_next_button_14_19' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_9' class='gform_page' data-js='page-field-id-19' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_9' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_9\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Harnwegsbeschwerden<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_9'>(Beschwerden beim Wasserlassen, h\u00e4ufiger Harndrang, unwillk\u00fcrlicher Harnabgang)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='Harnwegsbeschwerden' class='gsurvey-likert' id='input_14_9'><thead><tr><th id='likert_col_1_14_9' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_9' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_9' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_9' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_9' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_9_1'    aria-labelledby='likert_col_1_14_9'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol1107b1565'  id='choice_14_9_2'    aria-labelledby='likert_col_2_14_9'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_9_3'    aria-labelledby='likert_col_3_14_9'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol1d2250c19'  id='choice_14_9_4'    aria-labelledby='likert_col_4_14_9'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_9' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_9_5'    aria-labelledby='likert_col_5_14_9'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_14_21' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zur\u00fcck'  \/> <input type='button' id='gform_next_button_14_21' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_10' class='gform_page' data-js='page-field-id-21' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_10' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_10\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Trockenheit der Scheide<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_10'>(Trockenheitsgef\u00fchl oder Brennen der Scheide, Beschwerden beim Geschlechtsverkehr)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='Trockenheit der Scheide' class='gsurvey-likert' id='input_14_10'><thead><tr><th id='likert_col_1_14_10' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_10' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_10' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_10' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_10' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_10_1'    aria-labelledby='likert_col_1_14_10'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol1107b1565'  id='choice_14_10_2'    aria-labelledby='likert_col_2_14_10'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_10_3'    aria-labelledby='likert_col_3_14_10'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol1d2250c19'  id='choice_14_10_4'    aria-labelledby='likert_col_4_14_10'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_10' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_10_5'    aria-labelledby='likert_col_5_14_10'\/><\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_14_22' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Zur\u00fcck'  \/> <input type='button' id='gform_next_button_14_22' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Weiter'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_14_11' class='gform_page' data-js='page-field-id-22' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_14_11' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_14_11\" class=\"gfield gfield--type-survey gfield--input-type-likert gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gsurvey-survey-field \"  data-field-class=\"gsurvey-survey-field\" ><label class='gfield_label gform-field-label' >Gelenk- und Muskelbeschwerden<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_14_11'>(Schmerzen im Bereich der Gelenke, rheuma\u00e4hnliche Beschwerden)<\/div><div class='ginput_container ginput_container_likert'><table aria-label='Gelenk- und Muskelbeschwerden' class='gsurvey-likert' id='input_14_11'><thead><tr><th id='likert_col_1_14_11' scope='col' role='presentation' class='gsurvey-likert-choice-label'>keine<\/th><th id='likert_col_2_14_11' scope='col' role='presentation' class='gsurvey-likert-choice-label'>leicht<\/th><th id='likert_col_3_14_11' scope='col' role='presentation' class='gsurvey-likert-choice-label'>mittel<\/th><th id='likert_col_4_14_11' scope='col' role='presentation' class='gsurvey-likert-choice-label'>stark<\/th><th id='likert_col_5_14_11' scope='col' role='presentation' class='gsurvey-likert-choice-label'>sehr stark<\/th><\/tr><\/thead><tbody><tr><td data-label='keine' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol1b3a9c22d'  id='choice_14_11_1'    aria-labelledby='likert_col_1_14_11'\/><\/td><td data-label='leicht' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol1107b1565'  id='choice_14_11_2'    aria-labelledby='likert_col_2_14_11'\/><\/td><td data-label='mittel' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol1b5a6bca0'  id='choice_14_11_3'    aria-labelledby='likert_col_3_14_11'\/><\/td><td data-label='stark' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol1d2250c19'  id='choice_14_11_4'    aria-labelledby='likert_col_4_14_11'\/><\/td><td data-label='sehr stark' class='gsurvey-likert-choice'><input name='input_11' type='radio' value='glikertcol1fb4ffe17'  id='choice_14_11_5'    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