Test February 27, 2017 Welcome to your Test name email What is your weight? What is your waist measurement (inches)? What is your hip measurement (inches)? Do you suffer from hot flushes or night sweats? No Occasionally Frequently Are you suffering memory loss? Occasionally Frequently No Do you have foggy thinking? No Occasionally Frequently Do you have mood swings? Occasionally Frequently no Do you suffer from vaginal dryness? Occasionally Frequently No Do you have breast tenderness? No Occasionally Frequently Do you have heavy or painful periods? No Occasionally Frequently Do you suffer water retention or bloating? No Occasionally Frequently Do you feel low or depressed? No Occasionally Frequently Do you have anxiety? No Occasionally Frequently Do you have fibroids or cysts? Yes No Are your periods irregular? Yes No Do you have acne breakouts? No Occasionally Frequently Do you have any unwanted hair growth? Yes No Do you have weight gain around the middle? Yes No Are you short tempered? Yes No Do you have increased sweating? No Occasionally Frequently Do you need to eat every few hours? No Occasionally Frequently Do you need more energy during the day? No Occasionally Frequently Do you suffer from constipation? No Occasionally Frequently Do you have brittle nails? Yes No Do you have dry skin? Yes No Does your hair come out in the shower or when brushing? No Occasionally Frequently Do you have cold hands or feet? No Occasionally Frequently Is your sex drive lower than you’d like? No Occasionally Frequently Are you struggling to lose weight? Yes No Do you have joint or muscle aches and pains? No Occasionally Frequently Do you suffer with PMS (bloating, cramps, heavy bleeding, mood swings)? No Occasionally Frequently Do you struggle to get out of bed in the morning? No Occasionally Frequently Do you feel stressed out or wired? No Occasionally Frequently Do you have trouble sleeping (falling asleep or waking up in the night)? No Occasionally Frequently Do you have sugar cravings? No Occasionally Frequently Time's up