Energy Levels

1. How would you describe your energy levels throughout the day? *

Full of energy all day long

I start strong but hit a slump in the afternoon

I feel tired most days, even with sleep

I’m constantly running on empty, no matter how much rest I get

Sleep Quality

2. How well do you sleep at night? *

I fall asleep easily and wake up refreshed

It’s hit or miss—sometimes okay, sometimes restless

I toss and turn, and I’m tired when I wake up

Sleep? What’s that? I feel exhausted no matter what

Weight Changes

3. Where do you notice weight gain, if any? *

I don’t struggle with weight gain

Mainly around my hips and thighs

My belly just won’t budge, no matter what I do

I’m gaining weight everywhere, especially in the belly

Mood Swings

4. How’s your mood these days? *

Pretty steady—I feel emotionally balanced

I get a bit irritable around my cycle, but nothing major

I’m moody and anxious more often than I’d like

I feel like I’m on an emotional rollercoaster—serious highs and lows

Menstrual Cycle (if applicable)

5. Is your menstrual cycle regular? (How were they when you had them?)

Like clockwork—always regular

It’s a little unpredictable but not concerning

Often irregular or I skip periods

Very irregular, painful, or completely absent

Cravings and Hunger

6. How often do you deal with cravings, especially for sweets or carbs? *

Hardly ever

Once in a while, especially before my period

Pretty frequently—I often crave something sweet or starchy

I can’t seem to control my cravings, they’re constant

Stress and Cortisol Levels

7. How do you manage stress? *

I stay calm and balanced, even when life gets busy

I get stressed occasionally, but I handle it okay

Stress is a regular part of my life, and it’s wearing me down

I feel overwhelmed, burnt out, and on edge most of the time

Libido (Sex Drive)

8. How’s your libido? *

Consistent and healthy

A bit lower than normal, but not too concerning

Noticeably lower than it used to be

Almost non-existent

Digestion and Bloating

9. How’s your digestion? *

Rarely have issues, everything’s running smoothly

Occasionally bloated or constipated

Frequently bloated, gassy, or constipated

Constant digestive discomfort—always bloated, gassy, or constipated

Brain Fog and Focus

10. How often do you feel like your brain’s in a fog? *

Rarely—I’m sharp and focused

Occasionally, but it’s not a big deal

Frequently, and it’s affecting my productivity

Almost daily—it’s hard to focus, and I forget things easily

Hair and Skin

11. Have you noticed any changes in your hair or skin? *

No changes—everything’s healthy and normal

My skin’s a little drier, and my hair isn’t as full as it used to be

I’m noticing more hair loss, breakouts, or dryness

Significant hair thinning, dry skin, or acne

Temperature Sensitivity

12. Do you find yourself feeling too hot or too cold lately? *

Nope, I’m comfortable most of the time

I get a bit cold sometimes, but it’s manageable

I’m often freezing, especially in my hands and feet

I’m either burning up or freezing all the time—can’t find balance

Muscle and Joint Pain

13. Do you experience muscle or joint pain? *

Never—my body feels good

Occasionally, but nothing major

I get achy joints or muscles regularly

I feel stiff, sore, or in pain almost every day

Water Retention

14. Do you notice swelling or puffiness in your body? *

No swelling or water retention

Occasionally in my hands or feet, but it’s mild

Regular puffiness or swelling in my legs, hands, or face

Constant water retention or swelling

Overall Well-Being

15. How do you feel, overall? *

I feel great! My health is in check

I feel okay, but something feels a little off

I’m struggling with multiple symptoms that affect my life

I’m overwhelmed with how I’m feeling physically and mentally