Hormone Clarity Quiz

Hormone Clarity Quiz

Savvy B Wellness™
Name *

First NameLast Name
Email Address *
example@example.com
1. What is your age range?*

25-2930-3435-3940-4445-4950+
2. Are you suffering from Estrogen Dominance? (Select all that apply)*

Heavy periods or clottingBreast tenderness before your cycleMood swings or irritabilityBloating or weight gain in hips/thighsN/A
Estrogen Dominance Score
2. Are you suffering from Estrogen Deficiency? This may occur from 25-34 yrs of age. (Select all that apply)*

Hot flashes or night sweatsVaginal dryness or discomfortThinning hair or dry skinIrregular or skipped periodsN/A
Estrogen Deficiency Score
3. Are you suffering from Progesterone Deficiency? (Select all that apply)*

Short cycles or irregular periodsTrouble falling or staying asleepAnxiety or racing thoughtsSpotting before your periodN/A
Progesterone Score
4. Are you suffering from Cortisol Imbalance? (Select all that apply)*

Afternoon crashes or fatigueFeeling "wired but tired" at nightDigestive issues under stressFrequent headaches or low back painN/A
Cortisol Score
5. Are you suffering from Insulin Resistance? (Select all that apply)*

Cravings for sugar or carbsBelly weight that won’t budgeSlow metabolism despite healthy eatingDark patches on skin (neck/armpits)N/A
Insulin Score
6. Are you suffering from PCOS?(Select all that apply)*

Irregular or missed periods (cycle longer than 35 days or fewer than 8 per year)Unexplained weight gain, especially around the belly, or difficulty losing weightAcne, dark patches on skin, excess hair growth, or hair thinningFertility struggles or difficulty ovulatingN/A
PCOS Score
7. Are you suffering from Thyroid Imbalance? (Select all that apply)*

Feeling cold all the timeHair thinning or sheddingBrain fog or memory issuesConstipation or dry skinN/A
Thyroid Score
8. Are you suffering from Testosterone Imbalance? (Select all that apply)*

Adult acne or oily skinExcess facial hairIrregular or missed periodsMoodiness or rageN/A
Testosterone Score
9. Are you suffering from DHEA Deficiency? (Select all that apply)*

Low energy or burnoutDecreased immunityLow libido or driveFeeling overwhelmed easilyN/A
DHEA Score
10. Are you suffering from Poor Sleep Regulation? (Select all that apply)*

Can’t fall or stay asleepRestless nights or vivid dreamsRelying on melatonin or sleep aidsWake up feeling exhaustedN/A
Poor Sleep Score
11. Are you suffering from Perimenopause? This may occur from 35+ yrs of age. (Select all that apply)*

Hot flashes or night sweatsShorter or longer cyclesVaginal dryness or painLoss of interest in sexN/A
Perimenopause Score
12. Are you suffering from Adrenal Fatigue? (Select all that apply)*

You feel wired but tired, especially at nightYou’ve noticed dark under-eye circles or salt/sugar cravingsYou rely on caffeine just to feel “normal”It takes longer to recover from stress, illness, or workoutsN/A
Adrenal Score
13. Are you experiencing signs of Gut/Digestion Imbalance? (Select all that apply))*

Constipation, diarrhea, or IBS symptomsBad breath, even with good oral hygieneAcne, eczema, or unexplained skin issuesFood sensitivities or discomfort after certain mealsN/A
Gut/Digestion Score
14. Are you experiencing signs of Leptin Resistance? (Select all that apply))*

Constant hunger, even after mealsDifficulty losing weight even with exercise/diet changesEnergy crashes or brain fog after eatingFeeling “puffy” or inflamedN/A
Leptin Score
Is there anything else you are experiencing that you want to share with me?
(Be specific to your comfort level)
Total Score
Should be Empty: