How are your Energy levels?This question is required.
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High and consistent throughout the day
Average
Low - "I'm exhausted"
Hot Flashes, night sweats...
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They come and go....
So-so....
Yes all the time....
How would you rate your Sleep?
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I sleep great
I sleep ok. But have some mild sleep disturbance (trouble falling asleep getting up in middle of night)
I am not sleeping very well at all
Have you noticed any changes in your mood?
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Generally positive and stable
Occassional mood swings (mad, sad, irritable or anxious)
I'm having feelings of sadness or irritability (mad, sad, irritable or anxious)
Are you gaining weight in your belly?
Yes over 10 lbs
Yes but less than 10 lbs
no weight gain
How is your Sex Drive?
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High (I want sex daily)
So-so (Not wanting sex as much as I used to)
Low (Not as interested in sex these days)
What's your name?
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What's your email address? We'll deliver your results to your inbox as well.
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What is your phone number? We promise not to spam or sell your info- EVER.
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