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Hormone Screening for Women

Instructions:  0 means you have no symptoms of this type at all. 1 means you have very mild symptoms of this type. 5  would be moderate symptoms and 10 would mean you have severe symptoms of this type.

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    Fatigue*

    Mental Confusion*

    Decreased Sex Drive/Libido*

    Sleep Problems*

    Mood Changes/Irritability*

    Migraine/Severe Headache*

    Weight Gain*

    Hot Flashes*

    Hair Loss*

    Joint Pain/Muscle Aches*