How old are you?
12-24
25-37
37-49
50+
age
Do you experience irregular, missed, or unpredictable periods?
yes
no
some times
Have you noticed thinning hair on your scalp or widening part line?
Yes
No
Do you struggle with weight gain or difficulty losing weight despite lifestyle efforts?
yes
no
sometimes
Have you noticed thinning hair on your scalp or widening part line?
yes
no
sometimes
Do you notice excess facial or body hair (chin, upper lip, chest, stomach)?
Yes
no
Do you experience persistent acne (especially jawline, chin, or cheeks)
yes
no
sometimes
Do you feel like you rarely or never ovulate (based on tracking or symptoms)?
yes
no
some times
Do you go more than 35 days between periods or skip months?
yes
no
sometimes
Do you struggle with weight gain or difficulty losing weight despite lifestyle efforts?
Yes
No
some times
Do you experience sugar cravings, energy crashes, or possible insulin resistance symptoms?
yes
no
sometimes
Do you have darkened skin patches (neck, underarms, or skin folds)?
Yes
No
sometimes
Have you experienced difficulty conceiving or been told you may have ovulation issues?
Yes
No
Do you experience fatigue, brain fog, anxiety, or mood swings that feel hormone-related?
Yes
No
sometimes
Do you have a family history of PCOS, diabetes, or metabolic disorders?
Yes
No
maybe
Have you experienced a change in sleeping patterns
Yes
No
maybe
Have you experienced anxiety or depression?
Yes
No
sometimes
have you had lab work showing high testosterone
Yes
No
Full Name
Email
*
