Female Hormonal Questionnaire
Category 1: For those with ovaries and uterus.

PMS before your period starts.

Please put a check next to any symptoms you experience during one month’s cycle.

Anxiety
Depression
Feeling sad
Crying spells
Suicidal thoughts
Irritability
Mood swings
Acne
Swollen or tender breasts
Feeling tired
Sleeping more than normal
Trouble sleeping
Upset stomach
Bloating
Constipation
Diarrhea
Headache
Backache
Appetite changes
Food cravings
Joint pain
Muscle pain
Trouble with concentration
Trouble with memory
Tension in the back of head
Tension in the neck
Tension in the shoulders
Please also fill in the form below for personal support and also so we can answer any of your questions.
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