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YOUR HORMONES • YOUR HEALTH • YOUR WELL-BEING

Hormone Balance Quiz

Not feeling like yourself lately?

Fatigue, brain fog, changes in weight, poor sleep, low libido—or simply feeling off—can have many possible causes.

Take our quick 2-minute quiz to explore your symptoms, recognize patterns, and learn when it may be worth looking deeper.

About 2 minutes • Educational, not diagnostic



SLEEP



ENERGY



MENTAL CLARITY



MOOD



METABOLISM



SEXUAL WELLNESS

Step 1 of 6 - Energy + Mood

16%

Energy + Mood + Mental Clarity

Thinking about the past 3 months, how often have you experienced the following?

I feel tired or low on energy, even after getting enough rest.(Required)

Never

Rarely

Sometimes

Often

Almost Always

My mood feels off lately—more irritable, emotional, or anxious.(Required)

Never

Rarely

Sometimes

Often

Almost Always

I have trouble focusing, remembering things, or finding the right words.(Required)

Never

Rarely

Sometimes

Often

Almost Always

Body Changes

Next, think about changes you've noticed in your body.

My weight has increased or become harder to manage, even though my habits haven't changed.(Required)

Never

Rarely

Sometimes

Often

Almost Always

I feel like I'm losing muscle or having a harder time maintaining it.(Required)

Never

Rarely

Sometimes

Often

Almost Always

I've noticed more hair shedding or thinning than usual.(Required)

Never

Rarely

Sometimes

Often

Almost Always

My periods are irregular or unpredictable.(Required)

N/A

Never

Rarely

Sometimes

Often

Almost Always

My periods interfere work, sleep, exerecise, or daily life.(Required)

N/A

Never

Rarely

Sometimes

Often

Almost Always

I have joint pain and/or muscle aches.(Required)

Never

Rarely

Sometimes

Often

Almost Always

Sleep + Temperature Changes

For this section, think about your sleep and any changes in how your body handles temperature.

I have trouble falling asleep or staying asleep.(Required)

Never

Rarely

Sometimes

Often

Almost Always

I experience hot flashes or night sweats(Required)

Never

Rarely

Sometimes

Often

Almost Always

I sweat more than I used to.(Required)

Never

Rarely

Sometimes

Often

Almost Always

I am always cold.(Required)

Never

Rarely

Sometimes

Often

Almost Always

Sexual Wellness

Hormone changes can also affect sexual wellness. These questions might not apply to everyone.

I have less interest in sex than I used to.(Required)

Never

Rarely

Sometimes

Often

Almost Always

I experience vaginal dryness or discomfort during sex.(Required)

N/A

Never

Rarely

Sometimes

Often

Almost Always

I have trouble getting or maintaining an erection.(Required)

N/A

Never

Rarely

Sometimes

Often

Almost Always

What Matters Most To You?

Now that you have thought through your symptoms, tell us what you'd most like help with?

What would you most like help with?(Required)

Hormone balance

Energy & feeling better

Weight & Metabolism

Sleep

Sexual wellness

I'm not sure—I just want to feel like myself again.

Select all that apply

Is there anything else you'd like us to know?

You're almost there!

Your symptoms are clues. Labs can help us look deeper. Hormone changes can overlap with thyroid function, nutrient levels, sleep, metabolism, and other factors. Share your information below and our team can help review what the next best step would be.

First Name(Required)

First Last

Email Address(Required)

Phone Number(Required)

How would you prefer to be contacted?(Required)

Call

Text

Email

How did you hear about us?

Facebook

Instagram

Friend or Family Referral

Google Search

Event

Other

Would you like to hear more from AVIVA about hormone health?

Yes, send me helpful emails from AVIVA about hormone health, symptoms, testing, and treatment options. I can unsubscribe at any time.

Utah’s leading provider for sexual health, hormone replacement therapy, and cosmetic injections

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HORMONE BALANCE QUIZ

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