Female Hormone Please answer yes or no if you currently are experiencing these symptoms (pre-menopausal or peri-menopausal) or if you have ever experienced these symptoms (post-menopausal):1. Do you have irregular menstrual periods?YesNo2. Do you have cramps with your periods?YesNo3. Do you get breast tenderness with your periods?YesNo4. Do you get moody or irritable around your period?YesNo5. Are your periods heavy (more than 2-3 days)?YesNo6. Do you have uterine fibroids?YesNo7. Do you have trouble falling asleep at night?YesNo8. Have you ever had a miscarriage or trouble getting pregnant?YesNo9. Do you get anxiety or panic attacks?YesNo10. Do you take or have you taken birth control pills in the past 2 years?YesNo11. Have you ever gone more than 3 months without a period?YesNo12. Have you ever had depression or post-partum depression?YesNo13. Do you get headaches or migraines around you period?YesNo14. Do you ever have cravings for sugar, salt, fat, or chocolate?YesNo15. Do you have discomfort or pain during sexual intercourse?YesNo16. Do you get bloating or water retention around your period?YesNo17. Do you have a family history of breast, uterine, or ovarian cancer?YesNo18. Do you have endometriosis?YesNo19. Have you had oily skin or acne?YesNo20. Was your last menstrual period over 1 year ago?YesNo21. Do you get "hot flashes" or "hot flushes"?YesNo22. Do you get severe sweating at night?YesNo23. Do you have vaginal dryness?YesNo24. Do you notice a decreased libido?YesNo25. Have you ever or do you take hormone replacement?YesNo26. Have you had a hysterectomy?YesNo27. Do you get urinary tract infections?YesNo28. Are you concerned about osteoporosis or hip/spinal fracture?YesNoName* First Last Email* PhoneThis field is for validation purposes and should be left unchanged.