Skip to content

HOME
ONLINE STORE
PATIENT PORTAL
BLOG

TOP MENU 24

AustinMD Aesthetics & Wellness

Functional Medicine, IV Vitamins – Medical Aesthetics – Cedar Park, Texas

DR. ROY
ABOUT
AESTHETICS
FUNCTIONAL MEDICINE
IV THERAPY
MORE SERVICES
REVIEWS
CONTACT

DR. ROY
ABOUT
AESTHETICS
FUNCTIONAL MEDICINE
IV THERAPY
MORE SERVICES
REVIEWS
CONTACT

Hormone Quiz

You are here:

Home
Quizzes and Surveys
Hormone Quiz

Can BHRT help you? Take this Hormone Quiz to find out.

The AustinMD Aesthetics and Wellness Hormone Quiz

AustinMD Hormone Quiz

NOTE: YOU MUST ANSWER ALL QUESTIONS. RESULTS ARE DISPLAYED ON THE PAGE AFTER COMPLETION

Sex(Required)

Male

Female

Date of Birth(Required)

MM slash DD slash YYYY

Adrenal Fatigue Symptoms

Do you crave salty/sweet foods?(Required)

Yes

No

Do you need caffeine to wake up and or keep you going?(Required)

Yes

No

Do you feel run down and stressed?(Required)

Yes

No

Do you get tired for no reason?(Required)

Yes

No

Do you find it is hard to rebound from stresses and illness?(Required)

Yes

No

Do you have joint or muscle pain?(Required)

Yes

No

Do you have hair loss?(Required)

Yes

No

Do you notice you have more allergies to foods or the environment?(Required)

Yes

No

Do you experience increased energy sometimes at night(Required)

Yes

No

Do you feel rested in the morning after a nights sleep?(Required)

Yes

No

Thyroid Symptoms

Do you have afternoon fatigue?(Required)

Yes

No

Do you have difficulty losing weight?(Required)

Yes

No

Do you find it hard to concentrate?(Required)

Yes

No

Do you have dry skin?(Required)

Yes

No

Do you have cold hands and feet?(Required)

Yes

No

Do you have high cholesterol?(Required)

Yes

No

Do you notice your hair thinning?(Required)

Yes

No

Do you experience anxiety and or depression?(Required)

Yes

No

Do you have thinning eyebrows/eyelashes?(Required)

Yes

No

Female Sex Hormone Imbalance Symptoms

Have you lost your zest for life?

Yes

No

Do you experience hot flashes?

Yes

No

Do you have night sweats?

Yes

No

Do you have decreased interest/desire in sex?

Yes

No

Do you have vaginal dryness?

Yes

No

Do you experience brain fog?

Yes

No

Do you experience incontinence or urinate frequently?

Yes

No

Do you have difficulty sleeping?

Yes

No

Female Testosterone Symptoms

Do you noticed a decreased/lack of drive?

Yes

No

Has your self confidence declined?

Yes

No

Do you lack initiative?

Yes

No

Do you notice a decrease in your sense of well being?

Yes

No

Do you have a difficult time making decisions?

Yes

No

Have you lost muscle mass, strength/tone?

Yes

No

Have you noticed a decline in your mental sharpness or focus?

Yes

No

Do you find you are more irritable?

Yes

No

Estrogen Dominance and /or Progesterone symptoms

Do you have decreased libido?

Yes

No

Do you have premenstrual mood swings?

Yes

No

Do you have premenstrual breast tenderness?

Yes

No

Do you have migraine headaches?

Yes

No

Do you have irregular/painful menstrual cycles?

Yes

No

Do you have uterine fibroids?

Yes

No

Do you have fibrocystic breast disease?

Yes

No

Do you have endometriosis?

Yes

No

Have you had problems with fertility?

Yes

No

Do you have joint/muscle pain?

Yes

No

Male Testosterone Symptoms

Do you experience a lack of drive?

Yes

No

Have you gained weight around your mid section/ waist?

Yes

No

Has your sex drive decreased?

Yes

No

Are you less assertive?

Yes

No

Do you have a decline in your sense of well being?

Yes

No

Are you increasingly irritable?

Yes

No

Do you find it difficult to set goals?

Yes

No

Do you experience a decline in your mental sharpness/memory?

Yes

No

Has your stamina and endurance decreased?

Yes

No

Do you have a difficult time making decisions?

Yes

No

Do you have fatigue?

Yes

No

Male Thyroid Symptoms

Do you sleep as well at night?

Yes

No

Do you have afternoon fatigue?

Yes

No

Do you have dry skin?

Yes

No

Do your muscles/joints ache?

Yes

No

Do you have decreased body hair?

Yes

No

Do you have headaches?

Yes

No

Do you experience fund retention?

Yes

No

Is your voice hoarse?

Yes

No

Do you have low blood pressure?

Yes

No

Do you have thinning of your eyebrows or eyelashes?

Yes

No

Do you have decreased sweating?

Yes

No

Submission

Name(Required)

First Last

Email(Required)

Phone(Required)

Zip Code(Required)

ZIP Code

Communication Agreement(Required)

By clicking the submit button below, I agree to receive communication via email or text from AustinMD Aesthetics & Wellness.

Δ

Read Our Reviews

Questions? Call us!

+1 (512) 593-5605

Schedule Consultation

Our Location

Cedar Park, Austin, Texas

13625 Ronald Reagan Blvd Building 10, Suite 200, Cedar Park, TX 78613, USA | Get Directions

Tuesday to Friday: 9am – 5pm
Saturday: 9am – 1pm

Stay Informed. Follow Us!

Facebook Icomoon-the7-font-instagram Youtube Google

© Copyright 2023 AustinMD | Site by Yakadanda

About
Contact
Privacy Policy
Terms and Conditions

About
Contact
Privacy Policy
Terms and Conditions

Interested in Pricing?