Integrative Medicine Dallas5330 Alpha Road, Suite 100 Dallas TX 75420
214-205-0012

Women’s Hormone Questionnaire

Check the symptoms you are experiencing to find out if you may be suffering from a significant hormone imbalance.

Women’s Estrogen Hormone Profile Test

 Achy, joint pains Anxiety Apathy and Malaise Bloating Bone Loss (Osteoporosis) Difficulty concentration Foggy thinking, unable to focus Food Cravings Frequent Bladder Infections Headaches Heart Palpitations Hot Flashes Incontinence or Urinary Stress Insomnia Lethargy or Depression Low Libido (sex drive) Low self esteem or sense of well being Memory Lapses Migraines Mood Swings Night Sweats PMS symptoms Reduction in Breast Fullness Sleep Disturbances Swelling, puffiness, water retention Tearfulness Vaginal Dryness & Irritation Weight Gain

Progesterone Hormone Profile Test

 Anxiety & Moodiness Breast Enlargement Cyclical Headache-Migraines Heavy Menses Irregular Periods Irritability & Quick to Anger Not Ovulating Painful Menstrual Cramps Puffiness and Bloating Short Term Memory Loss Sleep Disturbances - Insomnia Sugar Cravings - Hypoglycemia Tender Breasts Water Retention Weepiness - Tearfulness

Testosterone Hormone Profile Test

 Acne Aggression Anxiety or nervousness Decreased Flexibility Decreased Mental Ability Decreased Stamina Elevated triglycerides Excess body hair - face and arms Fatigue - Feeling "Burned Out" Fibromyalgia Foggy Thinking Heart Palpitations Hypogylcemia, unstable blood sugar Irritability Loss of Muscle & Muscle Mass Loss of scalp hair Low Libido (sex drive) Malaise - lack of drive or energy Oily skin Thinning skin
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Integrative Medicine Dallas
5330 Alpha Road, Suite 100
Dallas, TX 75420
Phone: 214-205-0012
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