Harmone Balance Test

Are your symptoms due to a hormonal imbalance? Do you need a saliva hormone test? You do not need a prescription to get your saliva hormones measured. It is simple and can be done in the comfort of your own home.
Please contact me: Brenda Bailey (cell) 208-260-0009 or (email) brenda.bailey.1@hotmail.com

Read carefully through the list of symptoms in each group, and put a check mark next to each symptom that you have. You can select off the same symptom in each group. Count the check marks in each group. In any group where you have two or more symptoms checked off, you could have the hormone imbalance represented by that group. The more symptoms you check off, the higher the likelihood that you have the hormone imbalance represented by that group. Some people may have more than one type of hormonal imbalance. This information is not intended to replace a doctor visit and is not intended as medical advice, but as a guideline for determining the underlying cause of your symptoms. You are encouraged to make your health care decisions with a qualified health care professional.

Symptom – Group 1
___ PMS ___Early Miscarriage ___ Unexplained weight gain ___ Insomnia
___ Anxiety ___ Infertility ___ Painful and/or lumpy breasts ___ Cyclical headaches Total ______

Symptom – Group 2
___ Vaginal dryness ___ Night sweats ___ Painful intercourse ___Bladder infections
___ Hot flashes ___ Memory problems ___ Lethargy/Depression
Total ______

Symptom – Group 3
___ Mood swings ___ Rapid weight gain ___ Puffiness and bloating ___ Insomnia
___ Anxious depression ___ Weepiness ___ Breast tenderness ___ Red flush on face
___ Cervical dysplasia ___ Migraine headaches ___ Heavy bleeding ___ Foggy thinking
Total ______

Symptom – Group 4
___ Combination of the symptoms in Group #1 and Group #3

Symptom – Group 5
___ Acne ___ Ovarian cysts ___ Excessive hair/face or arms ___ Infertility
___ Mid cycle pain ___ Thinning hair on head ___ Hypoglycemia ___ Polycystic ovaries
Total ______

Symptom – Group 6
___ Fatigue ___ Unstable blood sugar ___ Thin and/or dry skin ___ Foggy thinking ___ Brown spots on face
___ Intolerance to exercise ___ Low blood pressure Total ______