Test October 15, 2019 0 0 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. Time is Up! Share
