Women's Hormone Test
* Required
Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Do you suffer from hot flashes?
*
Yes
No
Do you suffer with night sweats?
*
Yes
No
Do you notice yourself feeling more stressed, anxious or nervous?
*
Yes
No
Have you recently gained weight primarily in your hips, abdomen, buttocks, or thighs?
*
Yes
No
Do you have trouble sleeping?
*
Yes
No
Is it harder to remember things
*
Yes
No
Do you feel depressed?
*
Yes
No
Have you lost interest in sex?
*
Yes
No
Do you feel irritable, angry, or impatient, without control over your emotions?
*
Yes
No
Do you have urinary leakage when you cough or sneeze?
*
Yes
No
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