BHRT CHECKLIST FOR MEN

example@example.com

	Never	Mild	Moderate	Severe
Decline in general well being (General state of health)
Joint pain/muscle ache (Lower back/joint/limb pain)
Excessive sweating (Sudden episodes/hot flash)
Sleep problems (Difficulty falling/staying asleep/wake up tired)
Increased need for sleep (Feel tired often)
Irritability (Aggressive/easily upset/moody)
Nervousness (Inner tension/restlessness)
Anxiety (Feeling panicky)
Depressed mood (Feeling down/sad/lack of drive/nothing of any use)
Exhaustion/lacking vitality (Decreased performance & activity/lack of interest/motivation)
Declining Mental Ability/Focus/Concentration
Feeling you have passed your peak
Feeling burned out/hit rock bottom
Decreased muscle strength
Weight Gain/Belly Fat/Inability to Lose Weight
Breast Development
Shrinking Testicles
Rapid Hair Loss
Decrease in beard growth
New Migraine Headaches
Decreased desire/libido
Decreased morning erections
Decreased ability to perform sexually
Infrequent or Absent Ejaculations
No Results from E.D. Medications