Female Hormone Imbalance Quiz

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

Confirm Email

3

In the past year, have you noticed any changes in your menstrual cycle, such as irregular periods or missed cycles?* This field is required.

Yes, frequently

Occasionally

No changes

4

Have you experienced hot flashes or sudden feelings of warmth spreading through your upper body and face?* This field is required.

Several times a day

A few times a week

Rarely or never

5

Do you struggle with night sweats that disrupt your sleep?* This field is required.

Almost every night

Sometimes

Not at all

6

How often do you feel fatigued or unusually tired, despite getting enough sleep?* This field is required.

Daily

A few times a week

Rarely or never

7

Have you noticed an increase in unwanted facial or body hair?* This field is required.

Yes, significantly

Mild increase

No change

8

Are you experiencing difficulty in managing your weight, despite no significant changes in diet or exercise?* This field is required.

Yes, it's been challenging

Slightly difficult

Not at all

9

How would you describe your mood over the last few months?* This field is required.

Frequent mood swings

Occasionally moody

Stable and consistent

10

Do you often feel cold, even in warm settings?* This field is required.

Very often

Sometimes

Rarely

11

Have you noticed any thinning of your hair on your scalp?* This field is required.

Significant thinning

Slight thinning

No thinning

12

How often do you experience forgetfulness or difficulty concentrating?* This field is required.

Frequently

Occasionally

Rarely

13

Have you had any issues with dry skin or brittle nails?* This field is required.

Yes, noticeably so

Somewhat

Not really

14

Do you often feel bloated or experience discomfort in the lower abdomen?* This field is required.

Very often

Sometimes

Rarely

15

How would you rate your libido (sex drive) lately?* This field is required.

Lower than usual

About the same

Higher than usual

16

Have you noticed any changes in your breast tissue, such as tenderness or lumpiness?* This field is required.

Yes, noticeable changes

Minor changes

No changes

17

Do you have frequent headaches or migraines?* This field is required.

Very frequently

Occasionally

Rarely or never

18

How often do you feel anxious or depressed without any apparent reason?* This field is required.

Very often

Sometimes

Rarely

19

Have you experienced any unexplained changes in your appetite or taste preferences?* This field is required.

Yes, significantly

Slightly

Not at all

20

Do you have difficulty falling asleep or staying asleep through the night?* This field is required.

Frequently

Occasionally

Rarely

21

Have you been diagnosed with high cholesterol or high blood pressure recently?* This field is required.

Yes

Not recently, but in the past

No

22

Considering your overall energy levels, how would you compare them to a year ago?* This field is required.

Much lower

Somewhat lower

About the same or better

23

How familiar are you with the signs and symptoms of hormone imbalances such as those seen in menopause, perimenopause, PCOS, and thyroid disorders?* This field is required.

Very familiar—I can list symptoms and potential treatments.

Somewhat familiar—I know a few symptoms but not much about treatment.

Not familiar—I have limited knowledge about hormone imbalances.

24

Have you or someone close to you ever been diagnosed with a hormonal imbalance?* This field is required.

Yes, I have been diagnosed myself.

Yes, someone close to me has been diagnosed.

No, I don't know anyone personally.

25

How open are you to exploring alternative and holistic treatment options for managing hormone imbalances?* This field is required.

Very open—I'm interested in exploring all options available.

Somewhat open—I'd consider it after traditional methods.

Not open—I prefer sticking with conventional medical treatments.

26

Do you know anyone who has experienced similar symptoms of hormone imbalance, and if so, how has it affected their life?* This field is required.

Yes, and it significantly impacted their quality of life.

Yes, but it did not majorly affect their daily activities.

No, I don't know anyone with such symptoms.

27

How proactive are you about educating yourself on health issues like hormone imbalances?* This field is required.

Very proactive—I regularly research and follow the latest developments.

Somewhat proactive—I learn about it when necessary.

Not very proactive—I rely on information from medical professionals only.

28

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