Pre-Study Questionnaire

Study #KVM20424

Study Title: Consumer Test - Vulvovaginal Moisturizer 2.0

Please complete this questionnaire before you begin using the product.

Reminder: All responses are kept strictly confidential and you will not be identified in any research reporting, documentation, or publications.

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* 1. Please enter today's date.

Date

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* 2. Enter your email address.
(Please use the same email address you provided on previous forms.)

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* 3. How would you rate the severity of your vulvar/vaginal dryness, on average, over the last 7 days?

0 (None)

5 (Moderate)

10 (Severe)

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 4. How would you rate the severity of your vulvar/vaginal discomfort or irritation, on average, over the last 7 days?

0 (None)

5 (Moderate)

10 (Severe)

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 5. How would you rate the severity of your vulvar/vaginal itching, on average, over the last 7 days?

0 (None)

5 (Moderate)

10 (Severe)

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 6. How would you rate the severity of your vulvar/vaginal stinging or burning, on average, over the last 7 days?

0 (None)

5 (Moderate)

10 (Severe)

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 7. How would you rate the severity of pain during intimacy, on average, over the last 7 days?

0 (None or N/A)

5 (Moderate)

10 (Severe)

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 8. Where do you typically experience symptoms of dryness, discomfort, itching, etc?

Vulva

Introitus (vaginal opening)

Vaginal canal

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* 9. Are you currently experiencing any of the following in the vulvar/vaginal area?

Thinning skin

Micro cuts

Discomfort from wiping

None of the above

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* 10. How often do you typically engage in vaginal sexual intercourse?

Not sexually active

Less than once a month

Once a month

2-3 times per month

1-2 times per week

3-4 times per week

5-7 times per week

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* 11. How often do you typically engage in masturbation?

N/A

Less than once a month

Once a month

2-3 times per month

1-2 times per week

3-4 times per week

5-7 times per week

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* 12. How much has vaginal dryness/sensitivity/etc decreased your ability to fully enjoy intimacy?

It hasn't

A little bit

Moderately

Significantly

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* 13. Do you use a vaginal lubricant during intercourse?

Sometimes

Yes

If so, please specify:

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* 14. What products or treatments have you tried to help with vulvar/vaginal dryness, sensitivity, itching, etc?

Non-Prescription Herbal Supplements

Prescription Hormone Therapy (e.g., vaginal cream or suppository)

Vaginal Lubricant (e.g., KY)

Vaginal Moisturizer (e.g., Replens)

Products/Devices (e.g., Fiera or Eros)

Vibrator

None

Other (please specify)

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* 15. How much do uncomfortable vulvar/vaginal symptoms concern you and impact your life?

0 (Not at all)

5 (Moderately)

10 (Significantly)

Clear

i We adjusted the number you entered based on the slider’s scale.

Pre-Study Questionnaire

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* 1. Please enter today's date.

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* 2. Enter your email address. (Please use the same email address you provided on previous forms.)

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* 3. How would you rate the severity of your vulvar/vaginal dryness, on average, over the last 7 days?

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* 4. How would you rate the severity of your vulvar/vaginal discomfort or irritation, on average, over the last 7 days?

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* 5. How would you rate the severity of your vulvar/vaginal itching, on average, over the last 7 days?

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* 6. How would you rate the severity of your vulvar/vaginal stinging or burning, on average, over the last 7 days?

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* 7. How would you rate the severity of pain during intimacy, on average, over the last 7 days?

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* 8. Where do you typically experience symptoms of dryness, discomfort, itching, etc?

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* 9. Are you currently experiencing any of the following in the vulvar/vaginal area?

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* 10. How often do you typically engage in vaginal sexual intercourse?

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* 11. How often do you typically engage in masturbation?

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* 12. How much has vaginal dryness/sensitivity/etc decreased your ability to fully enjoy intimacy?

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* 13. Do you use a vaginal lubricant during intercourse?

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* 14. What products or treatments have you tried to help with vulvar/vaginal dryness, sensitivity, itching, etc?

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* 15. How much do uncomfortable vulvar/vaginal symptoms concern you and impact your life?

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* 16. Is there anything else you think would be helpful for Kindra to know about your history/symptoms/experiences/etc?

* 2. Enter your email address.
(Please use the same email address you provided on previous forms.)