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Hormone Quiz
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Understand your hormonal imbalances in 5 minutes by completing this quiz.
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Before we identify your hormone type, tell me a bit about your weight loss struggles. How much weight do you want to lose?
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5 - 10 lbs
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11 - 20 lbs
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21 - 30 lbs
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31+ lbs
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How long have you wanted to lose this weight?
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Just the last few years.
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Since having children.
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More than 5 years.
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Well over a decade.
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I have always struggled with my weight.
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Are you still having your menstrual cycle?
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Yes
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No
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Tell me a little bit about your periods... select the radio button if the answer is true.
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My menstrual cycles are irregular - the cycles come too quickly or far apart or follow no pattern at all.
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I have PMS (mood swings, sadness or irritability the days leading up to my cycle).
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I have cramps.
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My periods are heavy.
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None of the Above
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Are you currently diagnosed with any of the following conditions?
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Endometriosis
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Fibroids
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Ovarian cysts
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Polycystic Ovarian Syndrome
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Recommended to have a Hysterectomy
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Infertility, miscarriage or premature ovarian failure
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None of the above
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I know you don't have periods any more but tell me a little bit about what your periods were like. Select the checkbox if the answer was true.
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My menstrual cycles were irregular - the cycles come too quickly or far apart or follow no pattern at all, especially after 40 years old.
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I had PMS (mood swings, sadness or irritability the days leading up to my cycle).
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I had cramps.
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My periods were heavy.
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I had a hysterectomy because of heavy periods or fibroids.
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I had a uterine ablation because my periods were heavy.
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None of the above
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Were you ever diagnosed with any of the following conditions?
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Endometriosis
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Fibroids
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Ovarian cysts
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Polycystic Ovarian Syndrome
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Infertility, miscarriage or premature ovarian failure
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None of the above
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Are you currently on Hormone Replacement Therapy for menopause?
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Yes
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No
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How often do you feel stressed or overwhelmed?
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Almost never.
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All the time.
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When I am at work.
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When I am at home.
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I handle stress during the day but I stress out in the evening.
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I am very stressed during the day but I tend to calm down at night.
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Do you often have an increased appetite or cravings?
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Yes
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No
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Have you been diagnosed with one of the following?
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Hypothyroid (low thyroid function)
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Hashimoto's disease
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Have not been diagnosed with thyroid problems, but I think I have them
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Graves disease
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None of the above
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Do you experience any of the following symptoms?
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Thinning hair on your head
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Thinning hair on the eye brows - loss of the outer edge of the brow
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Constipation
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Dry crusty heels - heavy calluses
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Very dry skin
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None of the above
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Where do you gain your weight?
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I gain around my waist, hips, thighs and my breasts.
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I gain weight around the middle.
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I gain just in the belly like a beach ball.
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I gain weight all over.
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I don't gain weight.
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Do you have any of the following sleep issues?
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Insomnia - can't fall asleep.
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Interrupted sleep - fall asleep but can't stay there.
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I have been diagnosed with Restless Leg Syndrome.
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I have been diagnosed with sleep apnea.
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I sleep like a champ
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Do you get night sweats?
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Yes
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No
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Have you been diagnosed with either of the following?
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Prediabetes
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Diabetes
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Hypoglycemia
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Gestational Diabetes
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None of the above
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Have you been diagnosed with either of the following?
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Prediabetes
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Diabetes
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Hypoglycemia
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Gestational Diabetes
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None of the above
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Let's talk about hunger and eating. Do experience any of the following? Check all that apply.
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I am hungry all the time. I need to eat every few hours.
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I get hungry in the evening and snack at night.
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I don't have a strong sense of hunger. I can go forever without eating.
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I experience sleepiness after meals. I just want to nap.
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 I can't eat until lunch time. I am never hungry in the morning.
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What diet approaches have you tried?
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High protein, low carb diet
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Paleo diet
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Ketogenic diet
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Low fat diet
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Vegetarian
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Vegan
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Elimination diet
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Managing macros
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When you are on a program, what is your biggest struggle with losing weight?
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Knowing what to do... I am great if I know what I need to do and how to do it!
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I need lots of accountability. I tend to self-sabotage.
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My family/friends/co-workers are my downfall. They pull me off my plan!
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I am so busy! I can't find the time to do it.
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I have no energy. I can't muster enough to do what I need to do to lose weight.
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I am an emotional eater. I am good until my mood gets the best of me.
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I last only for a short time and then I "fall off the wagon!"
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I really need extra support for when I hit a weight loss plateau or when I get stuck!
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