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Welcome to Hormone Balance Evaluation for WOMEN!
We are about to ask you a few simple questions to help us estimate how balanced your key hormones may be.
Let's get started!
Time is Up!
Welcome to Hormone Balance Evaluation for WOMEN! We are about to ask you a few simple questions to help us estimate how balanced your key hormones may be. Let's get started! How is your Energy Level?Like an Energizer BunnyTired but enough to get through the dayToo tired after work for anythingBarely make it through the day How is your mood? Happy-go-lucky most of the timeEven, neither bad nor goodMood siwngs, ups and downsSad and depressed a lot How is your mental sharpness? I am pretty sharp, no complaintsI think I used to be smarterIt's getting harder to keep up with othersConstant brain fog. I've never been like that! Do you get hot flashes and/or night sweats?NeverOccasionallyRegularly (once a week or less)Frequently (more than once a week) How is your sex drive?Same I had for yearsOK but less than what it used to be 5 years agoDefinitely decreasedNonexistent How is your sleep?Good, I feel fully rested in the morningI sleep every night but don't feel it's enoughI have trouble falling asleep, wake up oftenIt's a constant struggle; I feel exhausted in the morning How often you feel cold without a reason?NeverSometimesOftenConstantly: I never seem to be able to get warm Losing hair or brittle hair?Nothing unusualIt's getting noticeably worseI am beginning to really worry about my hair loss and breakageIt's a disaster! My hair is falling out every day! Skin getting dry and/or winkled?Nothing beyond what I consider normal for my ageMore than I am willing to accept but nothing seriousI think my skin is beginning to look much older than my ageThe way my skin looks is really worrisome, and it's only getting worse. How are your body weight and shape?I haven't noticed any recent changes in my weight or the way I lookI've gained a few pounds but in "all the right places"I've gained quite a few pounds especially around midsectionI've gained a lot of weight and my body shape has changed a lot (big belly, smaller hips, batwings, etc.) What is your age?18-3536-4546-5556 + That's it! To ensure privacy, we'll send you results via email. Your First Name Your Email I agree to receive the results of this evaluation and other communication from CT Hormone Therapy and Integrative MD via email. Time is Up!
Welcome to Hormone Balance Evaluation for MEN! We are about to ask you a few simple questions to help us estimate how balanced your key hormones may be. Let's get started! How is your Energy Level?ExcellentTired but enough to get through the dayToo tired after work for anythingBarely make it How is your mood?I am usually in good spiritsNeither good nor bad - just OKMood swings, ups and downs, get angry easilyBad most of the time How is your mental sharpness?Sharp as a tackNot what it used to be but I hold my ownAm I getting dumber or are others getting smarter?I' can't keep up with the pack anymore How much do you sweat?Normally - after a workout, on a hot day, etc.More than I used toToo often - even others notice itOften, a lot and for no good reason - something is definitely wrong How is your sex life?I haven't noticed any changes in my sex drive or performanceOK but I am slowing downMy drive and/or performance are causing concerns for me and/or my partnerI've lost interest in sex and/or have erectile dysfunction How is your sleep?Good, I feel fully rested in the morningI sleep every night but don't feel it's enoughI have trouble falling asleep, wake up oftenIt's a constant struggle; I feel exhausted in the morning How is your muscle strength?Good, no problems at the gymIt seems lower than before, especially when I push myselfI definitely feel weaker than beforeI am getting weaker and look flabby. Workouts don't seem to help. Joint and Muscle Pain?Rarely, and then there is always a reasonOccasionally, and it doesn't seem connected to excess workouts or traumaFrequently forcing me to change my exercise routine or cancel plansAll the time making my life more difficult How is your endurance?I have stamina like a horseI need to take extra breaks when I am doing something strenuousI need more rest than before even going around my daily routineI get so tired I need frequent breaks and long periods of rest Are you gaining weight?I've been able to keep the same weight and muscle mass for yearsI am a few pounds chubbier than I used to beI hate to admit but my belly is growingI've got a beer belly while my arms and legs are thinner and less muscular What is your age?18-3536-4546-5556 + That's it! To ensure privacy, we'll send you results via email. Your First Name Your Email I agree to receive the results of this evaluation and other communication from CT Hormone Therapy and Integrative MD via email. Time is Up!
Welcome to Hormone Balance Evaluation for MEN!
