Clone of Women's Hormone Quiz

1

In the last 2 weeks, have you experienced night sweats or unusual sweating?* This field is required.

None

Mild

Moderate

Severe

Very Severe

2

In the last 2 weeks, have you had sleep problems (difficulty falling asleep, sleeping through the night or waking up too early)?* This field is required.

None

Mild

Moderate

Severe

Very Severe

3

In the last 2 weeks, have you had an increased need for sleep or falls asleep easily after a meal?* This field is required.

None

Mild

Moderate

Severe

Very Severe

5

In the last 2 weeks, have you had problems with thinking, concentrating or reasoning?* This field is required.

None

Mild

Moderate

Severe

Very Severe

6

In the last 2 weeks, have you had difficulty learning new things?* This field is required.

None

Mild

Moderate

Severe

Very Severe

7

In the last 2 weeks, have you had trouble thinking of the right word to describe persons, places or things when speaking?* This field is required.

None

Mild

Moderate

Severe

Very Severe

8

In the last 2 weeks, have you had physical exhaustion (general decrease in muscle strength or endurance, decrease in work performance, fatigue, lack of energy, stamina or motivation)?* This field is required.

None

Mild

Moderate

Severe

Very Severe

9

In the last 2 weeks, have you had joint and muscular symptoms (joint pain or swelling, muscle weakness, poor recovery after exercise)?* This field is required.

None

Mild

Moderate

Severe

Very Severe

10

In the last 2 weeks, have you had an increase in frequency or intensity of headaches/migraines?* This field is required.

None

Mild

Moderate

Severe

Very Severe

11

In the last 2 weeks, have you had a depressive mood (feeling down, sad, lack of drive)?* This field is required.

None

Mild

Moderate

Severe

Very Severe

12

In the last 2 weeks, have you experienced irritability (mood swings, feeling aggressive, angers easily)?* This field is required.

None

Mild

Moderate

Severe

Very Severe

13

In the last 2 weeks, have you had anxiety (inner restlessness, feeling panicky, feeling nervous, inner tension)?* This field is required.

None

Mild

Moderate

Severe

Very Severe

14

In the last 2 weeks, have you had rapid hair loss or thinning?* This field is required.

None

Mild

Moderate

Severe

Very Severe

15

In the last 2 weeks, have you felt cold all the time or have cold hands or feet?* This field is required.

None

Mild

Moderate

Severe

Very Severe

16

In the last 2 weeks, have you had sexual problems (change in sexual desire or sexual performance)?* This field is required.

None

Mild

Moderate

Severe

Very Severe

17

In the last 2 weeks, have you had bladder problems (difficulty in urinating, increased need to urinate)?* This field is required.

None

Mild

Moderate

Severe

Very Severe

18

In the last 2 weeks, have you had Erectile changes, including weaker erections or loss of morning erections?* This field is required.

None

Mild

Moderate

Severe

Very Severe

19

In the last 2 weeks, have you had infrequent or absent ejaculations?* This field is required.

None

Mild

Moderate

Severe

Very Severe

20

In the last 2 weeks, have you experienced weight gain, increased belly fat, or difficulty losing weight?* This field is required.

None

Mild

Moderate

Severe

Very Severe

21

Total ScoreCalculated automatically from the selection scores.

22

Risk Level

23

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