1-Min Female Hormone QUIZ
First Name
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Last Name
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Phone
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Email
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Are you tired even after getting enough sleep and rest?
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Yes
No
Do you notice low libido or interest in sex?
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Yes
No
Do you have unexplained sleep changes (trouble falling asleep, trouble staying asleep, waking up too early, waking up groggy)?
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Yes
No
Do you notice weight gain and/or belly fat?
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Yes
No
Do you notice hair thinning or hair loss?
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Yes
No
Do you notice more skin sagging, dryness, and wrinkles?
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Yes
No
Do you have unexplained mood changes (irritable, short-fused, more anxious, depressed, overwhelmed)?
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Yes
No
Do you notice brain fog or poor memory (forgetfulness)?
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Yes
No
Do you notice a change in your temperature sensitivity (too hot, too cold, excess sweating, hot flashes, nightsweats)?
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Yes
No
Do you notice changes in your menses (irregular cycles, more or less bleeding, shorter cycles, longer cycles)?
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Yes
No