1. Do you still have monthly cycles? If so, are they becoming shorter or more irregular? YesNo
2. Do you struggle with fatigue at any point throughout the day? YesNo
3. Do you have issues with sleep, either falling asleep or staying asleep? YesNo
4. Have you gained weight in the past 3-6 months that seems to be specific to the abdomen, hips, and thighs? YesNo
5. Have you lost your desire to have sex? YesNo
6. When you do have intercourse, do you suffer from vaginal dryness or discomfort? YesNo
7. Do you get frequent urinary tract infections? YesNo
8. Do you struggle with focusing and staying on track with a particular task? YesNo
9. Do your loved ones and friends notice you are more irritable? Are you experiencing mood swings or an inability to handle stress? YesNo
10. Have you noticed an increased amount of facial hair lately? YesNo
11. Are you struggling with thinning hair, or hair loss? YesNo
12. Do you suffer from hot flashes throughout the day? YesNo
13. Do you often wake up in the middle of the night drenched in sweat? YesNo
14. Do you notice an increased amount of joint aches? Or, are you slower to recover from a workout? YesNo
15. Do you often feel anxious, or do you have less desire to do things you used to love? YesNo
I am interested in booking an appointment with you.
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