Hormone Assessment - check all the boxes that apply
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Last Name
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As you mark these boxes, please only click on the ones that seem relevant in the last 1-3 months.
High Cortisol (Overstimulated Stress Response) Cortisol is your body’s primary stress hormone. When it stays elevated for too long... Check any symptoms you experience often or during stressful seasons of life.
Difficulty falling asleep or staying asleep
Racing mind, anxiety, or "wired but tired" feeling
Salt cravings
Midsection (belly) weight gain
High blood pressure or heart palpitations
Muscle tension ( neck, shoulders, jaw)
Elevated fasting blood sugar
Frequent infections or slow healing
Feeling "on edge" or easily startled
Irregular or heavy cycles
PMS worsening with stress
Sugar or caffeine dependence
Feeling inflamed or puffy before period
Low Cortisol (Depleted Stress Response) Cortisol is your body’s primary stress hormone. When it runs too low after prolonged stress... Check any symptoms you experience often, especially when you feel exhausted, burned out, or unable to recover from stress.
Extreme fatigue, especially in the morning
Crashing mid-day (2-4pm energy drop)
Dizziness when standing up quickly
Low blood pressure
Low motivation, apathy
Difficult handling stress (feeling overwhelmed)
Carving sweet or salty foods
Brain Fog or forgetfulness
Feeling "flat" emotionally
Frequent illness or allergies
Cycle length getting longer ( ovulation delayed)
Low sexual interest
Feeling anxious or teary without clear reason
Hair thinning or shedding
High Estrogen (Estrogen Dominance Pattern) Estrogen is a key hormone that supports the menstrual cycle, mood, metabolism, and overall vitality. Check any symptoms you experience often or that tend to worsen before your period.
Swollen or tender breasts
Irregular period - heavy bleeding
Increased PMS Symptoms
Memory Issues
Sleep Issues
Weight Gain
Water Retention
Brain Fog
Low Estrogen (Estrogen Deficiency Pattern) Estrogen plays an important role in energy, mood, bone health, skin, and vaginal health. When estrogen runs low....Check any symptoms you experience often or that have increased during perimenopause, menopause, or after periods of high stress.
Joint Pain
Itchy ears
Increased cravings
Fatigue
Trouble concentrating | Memory
Hot flashes
Urinary concerns
Pain during Intercourse
Dry or Thinning Hair
Vaginal Dryness
Irregular periods - infrequent or absent cycles
Weight Changes
Insomnia
Progesterone is a calming hormone that supports sleep, mood, and cycle regularity. When progesterone is too high, it can contribute to...Check any symptoms you experience often or that feel more noticeable during the second half of your cycle.
Vaginal infections
weight gain
Water Retention
Bloating
Changes in appetite
Cramping
Fatigue
Mood Swings
Low Progesterone (Progesterone Deficiency Pattern) Progesterone is a calming hormone that supports sleep, mood, and cycle regularity. When progesterone runs low, it can contribute to...Check any symptoms you experience often or that tend to worsen during the second half of your cycle.
Headaches
Tender breasts
Body aches
Bloating
Depression
Anxiety
Irritability
Insomnia
High Testosterone (Elevated Androgen Pattern) Testosterone supports muscle strength, metabolism, confidence, and libido in women. When testosterone is too high, it can contribute to...Check any symptoms you experience often or that have become more noticeable over time.
Deep Voice
Enlarged Clitoris
Excess body Hair
Facial hair
irregular or absent menstrual periods and infertility
Severe acne
High Sex Drive
Testosterone supports muscle strength, energy, motivation, bone health, and libido in women. When testosterone runs low, it can contribute to...Check any symptoms you experience often or that have gradually increased over time.
Low sex drive
Fatigue
Depression
Anxiety
Loss of muscle strength and tone
Weight Gain
Vaginal dryness
Hot flashes and night sweats
Brain fog, and changes in cognition
Irregular menstrual cycles - effecting cycle regularity
Infertility
Thinning hair and dry skin
Low sexual satisfaction, and changes in sexual function
DHEA & Metabolic Chaos (Adrenal–Metabolic Imbalance Pattern) DHEA is a foundational adrenal hormone that supports energy, resilience, muscle tone, immune function, and healthy aging. When DHEA becomes imbalanced, it can disrupt metabolism and stress response, contributing to fatigue, low libido, difficulty building muscle, inflammation, poor stress tolerance, and feeling prematurely worn down. Check any symptoms you experience often or that have developed after long-term stress, illness, or burnout.
Low libido or lack of interest in intimacy
Fatigue despite adequate sleep
Difficulty building or maintaining muscle tone
Feeling "aged" prematurely
Chronic pain or inflammation
Poor immune resilience
Low stress tolerance
Loss of skin elasticity or dry skin
Thinning hair or eyebrow loss
Vaginal Dryness
Decreased motivation or creativity
Feeling "flat" or joyless
Who shared this assessment or how did you find it, so we can thank that individual?
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Out of all the checkboxes you picked, what are your top 2 or 3 you want to focus on?
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