Welcome to your Hormonal Balance Quiz Name Email Phone 1. How do you feel throughout the day? Energetic and stable Mild fatigue by afternoon Tired most of the day Exhausted even after a full night’s sleep None 2. How regular are your menstrual cycles? Very regular (28–32 days) Slightly irregular (± 3–5 days) Frequently irregular (6–10 day variation) Very irregular, missed periods, or cycles 35 days None 3. Which skin or hair symptoms do you experience most often? Clear skin and healthy hair Mild acne, dryness, or mild hair fall Moderate acne, pigmentation, or noticeable hair thinning Severe acne, excess facial hair, or significant hair loss None 4. How is your weight responding to diet and exercise? Easy to maintain Slight difficulty losing weight Very slow weight loss or easy weight gain Unable to lose weight despite consistent effort None 5. How often do you experience mood changes, irritability, or anxiety? Rarely Sometimes Often Almost daily None 6. How well do you sleep at night? Fall asleep easily and wake up refreshed Take some time to fall asleep Wake up multiple times or experience light sleep Insomnia or inability to stay asleep None 7. How would you describe your digestion? Regular and comfortable Occasional bloating or gas Frequent acidity, constipation, or bloating Severe digestive issues impacting daily life None 8. How intense are your PMS symptoms? Mild or none Moderate cramps or mood changes Severe cramps, headaches, or breast tenderness Debilitating PMS that affects routine None 9. How often do you experience strong cravings? Rarely Sometimes Often with energy crashes Daily cravings with irritability or shakiness when hungry None 10. Which of the following applies to you? None Mild hair thinning or dry skin Excess facial/body hair or bald patches Combination of acne, hair thinning, and facial hair None Time's up
