Women's Hormone Health Assessment
Female Hormone
Deficiency Questionnaire
Rate the severity of each symptom below. Your results will help our providers determine whether bio-identical hormone therapy may restore your vitality and quality of life.
How to Complete This Assessment
For each symptom below, select the severity that best describes your experience over the past 4 weeks. Be as honest and accurate as possible — your answers go directly to your provider before your consultation.
Your Results
Symptom assessment complete
Common Questions
About Hormone Deficiency & This Assessment
Answers to the questions women ask most before completing this questionnaire.
A female hormone deficiency questionnaire is a symptom assessment tool that helps identify signs of estrogen, progesterone, and testosterone imbalance. It evaluates symptoms such as hot flashes, night sweats, fatigue, mood changes, low libido, and sleep disturbances to determine whether bio-identical hormone replacement therapy may be appropriate.
Common symptoms include hot flashes, night sweats, unexplained fatigue, difficulty sleeping, mood swings, anxiety, depression, decreased libido, vaginal dryness, brain fog, weight gain especially around the abdomen, hair thinning, and irregular or absent periods.
You receive an instant symptom score and personalized recommendation. A Body Symmetry MD care coordinator will contact you within 1 business day to discuss your results and schedule a free consultation if appropriate.
Bio-identical hormone replacement therapy (BHRT) uses hormones chemically identical to those your body produces naturally. Under physician supervision, BHRT has been shown to effectively relieve menopausal and perimenopausal symptoms. Body Symmetry MD providers customize every treatment plan based on lab results and individual health history.
No. Hormone deficiencies can occur at any age. While perimenopause typically begins in a woman's 40s, hormonal imbalances affecting estrogen, progesterone, and testosterone can occur in women in their 30s or earlier due to stress, thyroid conditions, lifestyle factors, or surgical menopause.
This questionnaire is a screening tool, not a medical diagnosis. A formal diagnosis of hormone deficiency requires blood or saliva lab testing interpreted by a licensed medical provider — which Body Symmetry MD offers as part of the initial consultation process.