Hormone Quiz

Welcome to your Hormone Survey

First Name

Last Name

Email

Zip Code

Category A

I experience bloating or puffiness

I feel irritable or experience mood seings

I experience heavy or painful periods

I have gained weight or have difficulty loosing weight, especially around my hips , butt and thighs

I've been told I have fibroids

I sometimes cry over nothing

I get migraines or other headaches

I have brain fog

I have had gallbladder problems or had my gallbladder removed

Category B

I'm emotionally fragile and/or I feel nostalgic about the past.

I have difficulty with memory.

My periods are fewer than three days.

I struggle with anxiety, depression, or lethargy.

I have night sweats and/or hot flashes.

I've had trouble with recurrent bladder infections.

I sometimes have problems with urinary leakage.

I have difficulty sleeping and wake often at night.

My breasts are smaller and/or beginning to droop.

I have achy joints or am prone to joint injuries.

My sun-damaged skin is more noticeable.

I am noticing more fine lines and wrinkles.

I have dry or thinning skin.

I have no interest in sex.

I have vaginal dryness or pain with intercourse.

Category C

I experience PMS seven to ten days before my period.

I get headaches or migraines before my period.

I feel anxious often.

I have painful, heavy, or difficult periods.

My breasts are painful or swollen before my period.

I have had a miscarriage in the first trimester.

I experience restless legs, especially at night.

I have had difficulty getting pregnant (after trying for six or more months).

Category D

I have abnormal hair growth on my face, chest, and/ or abdomen.

I have acne.

I have areas of darker skin (e.g., armpits).

I've noticed thinning hair on my head.

I have skin tags.

I struggle with depression and/ or anxiety.

I have PCOS.

I have had difficulty getting pregnant (after trying for six or more months).

Category E

I have low libido or diminished sex drive

I struggle with depression, have mood swings, or cry easily.

I have no motivation.

I am tired or fatigued throughout the day or have been diagnosed with chronic fatigue syndrome.

I am unable to gain muscle, and I am losing muscle mass.

I have a decrease in bone density or have been diagnosed with osteopenia or osteoporosis.

I have urinary incontinence.

I have a loss of sexual fantasies.

I have difficulties or am unable to orgasm.

I have cardiovascular symptoms or heart disease.

I've had weight gain.

I have anxiety or panic attacks.

Category F

I feel tired in the morning, even after a full night's sleep.

I depend on caffeine to get through my day.

I want to take naps most days.

My energy crashes in the afternoon.

I crave salty or sweet food.

I'm dizzy when I stand up too quickly.

I feel at the mercy of stress.

I have difficulty falling asleep and/ or staying asleep.

My muscles feel weaker.

I get sick often and/ or have a difficult time getting over infections.

I have low blood sugar issues.

Category G

My life is crazy stressful.

I feel overwhelmed by stress.

I have extra weight around my midsection.

I have difficulty falling or staying asleep.

My body is tired at night, but my mind is going a mile a minute. I'm "wired and tired."

I get a second wind at night that keeps me from falling asleep.

I wake between 2 and 4 am and can't fall back to sleep.

I feel easily distracted, especially under stress.

I get angry quickly or just feel on edge.

I have high blood pressure or a fast heart rate.

I have elevated blood sugar or diabetes.

I get shaky if I don't eat often.

I'm prone to injury and have difficulty healing.

Category H

I have brain fog or feel like my memory isn't quite what it used to be.

I'm losing hair.

My hair is dry and tangles easily.

I'm constipated often and need a stimulant (like caffeine) to get a bowel movement.

I'm cold often and/or have cold hands and feet.

My periods are sporadic or occur more than thirty-five days apart.

I have joint or muscle pain.

I have dry skin.

I have had difficulty getting pregnant (after trying for six months or more) or have had a first trimester miscarriage.

I am in a low mood or struggle with depression.

I'm tired no matter how much I sleep.

I find it difficult to break a sweat.

I have recurrent headaches.

I have high cholesterol.

I have a hoarse voice most days.

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