Beyond Estrogen - Hormone Weight Management Quiz
Check all that apply to find your worst imbalance(s) and be patient :) there is alot to cover!
Your Name
*
First Name
Last Name
What is your age?
*
Email address to send your results
*
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1. I have strong cravings for sweets/carbs
*
Never
Occasional
Frequently
Much of the time
2. I have afternoon energy crashes
*
Rarely
Occasionally
Frequently
Most days
3. I have belly weight or can't lose despite effort
*
No, I don't
Yes, I do
4. I am sleepy after meals
*
Rarely
Occasionally
Frequently
Constantly
5. I have brain fog and/or poor mental stamina
*
Rarely
Sometimes
Often
Most of the time
6. I feel "wired and tired" or wake during the night
*
No or rarely
Occasionally
Frequently
Almost Daily
7. I do stress snacking or have chocolate cravings under stress
*
Not really
Sometimes
Frequently
All the time
8. I have afternoon slumps then a second wind at night
*
No or rarely
Occasionally
Frequently
Constantly
9. I have stubborn belly fat
*
No
Mild
Moderate
Severe
10. My mind is restless at bedtime
*
No
Mild/occasional
Moderately/frequently
Severely/all the time
11. I have cold hands/feet or feel colder than others
*
No
Sometimes
Often
All the time
12. I notice thinning hair or outer eyebrow thinning
*
No
Mildly
Moderately
Significantly
13. My metabolism is slow and I seem to gain weight easily
*
Not noticeable
Mildly
Moderately
Severely
14. I have low energy even on good sleep
*
No or rarely
Occasionally
Sometimes
Often
15. Do you experience constipation and/or dry skin?
*
No
Occasional
Often
Most of the time
16. I have bloating and/or fluid retention
*
Rarely
Occasionally
Frequently
All the time
17. I notice mood swings or irritability
*
Rarely
Sometimes
Often
Much of the time
18. Weight centered in hips/highs or new midsection fat post-menopause
*
No
Mild
Moderately
Significantly
19. Breast tenderness
*
Not at all
Mild
Moderate
Significantly/often
20. Hot flashes and/or palpitations
*
No or rarely
Occasionally/Mild
Frequently/Moderate
Daily or Severe
21. My sleep is lighter or more broken
*
No
Occasionally
Frequently
Almost always
22. I have anxiety or nervousness
*
No
Occasionally
Frequently
Often
23. I notice bloating/water retention
*
No
Occasionally/mild
Frequently/moderate
Often/significantly
24. I notice more headaches
*
No
Occasionally
Sometimes
Often
25. I notice thinner and/or sagging skin
*
No
Mild
Moderate
Significantly/Severe
26. It is harder for me to build and/or keep muscle
*
No
Occasionally/mild
Frequently/moderately
Often/severe
27. My libido is low
*
No
Occasionally/mild
Frequently/moderately
Almost always/severely
28. I have low stamina and/or drive to start tasks
*
No
Occasionally/mild
Frequently/moderate
Almost always/severely
29. I notice slower recovery from activity and/or workouts
*
No
Occasionally/mild
Frequently/moderate
Almost always/severe
30. My sexual satisfaction is diminished
*
No
Occasionally/mildly
Frequently/moderately
Almost always/severely
31. I have low morning energy even after full sleep
*
No
Occasionally
Frequently
Almost always
32. I am sore and/or slow to recover after activity
*
No
Occasionally/mild
Frequently/moderately
Almost always/severely
33. I have more difficulty maintaining muscle
*
No
Occasionally
Frequently
Almost always
34. I have saggy skin, particularly around the jaw and neck (jowls).
*
No
Mild
Moderate
Significantly/Severely
35. I notice a decrease in sweating
*
No
Mild
Moderate
Distinctly
36. I rarely feel truly full
*
No
Occasionally
Frequently
Almost always/most of the time
37. I continue to eat after meals and/or need seconds
*
No
Occasionally
Frequently
Almost always
38. My weight plateaus despite calorie restriction
*
No
Mild
Moderate
Severely
39. I nibble late at night
*
No
Occasionally
Frequently
Almost always
40. I have low motivation to exercise
*
No
Occasionally/Mild
Frequently/Moderate
Almost always/Severely
41. I am frequently hungry between meals
*
No
Occasionally
Frequently
Almost always
42. I have increased digestive issues such as gastritis or IBS
*
No
Occasionally
Frequently
Almost always
43. I rarely feel satieted
*
No
Occasionally
Frequently
Almost all the time
44. I frequently "graze" or snack
*
No
Occasionally
Frequently
Almost always
45. I get "hangry" if meals are delayed
*
No
Occasionally
Frequently
Almost always
46. I have higher body fat% even when weight is stable
*
No
Mild
Moderate
Significantly
47. I have both hot flashes and increased abdominal fat
*
No
Mild
Moderately
Severe/significantly
48. My blood lipid profile has demonstrated decreased HDL and increased triglycerides
*
No
Mild change
Moderate Change
Significant/Severe change
49. I have increased anxiety and/or depressive symptoms
*
No
Occasionally/Mild
Frequently/Moderate
Often/Severe
50. I notice increased soreness, inflammation and or puffiness after certain foods
*
No
Occasionally
Frequently
Often/almost always
Insulin
Cortisol
Thyroid
Estrogen
Progesterone
Testosterone
Growth Hormone
Leptin
Ghrelin
Adiponectin
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