HRT Quiz 1. Hot flashes, sweating (episodes of sweating)
2. Heart discomfort (unusual awareness of heart beat,heart skipping, heart racing, tightness)
3. Sleep problems (difficulty in falling asleep, difficulty in sleeping through the night, waking up early)
4. Irritability (feeling nervous, inner tension, feeling aggressive)
5. Depressive mood (feeling down, sad, on the verge of tears,lack of drive, mood swings)
6. Anxiety (inner restlessness, feeling panicky)
7. Physical and mental exhaustion (general decrease in performance,impaired memory, decrease in concentration, forgetfulness)
8. Sexual problems (change in sexual desire,in sexual activity and satisfaction)
9. Bladder problems (difficulty in urinating, increased need to urinate,bladder incontinence)
10. Dryness of vagina (sensation of dryness or burning in the vagina,difficulty with sexual intercourse)
11. Joint and muscular discomfort (pain in the joints,rheumatoid complaints)
Please share any additional comments about your symptoms you would like to address.
Do you have cold hands and feet?
Do you have gas, bloating or abdominal pain after eating?
Do you have daily bowel movements?
Please select your WEEKLY Activity Level based on this criteria. (Physical activity that accelerates heart rate / Breathlessness)
Please list any prior hormone therapy?
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