Hormone Balance Quiz

Saliva testing is a simple, accurate way to determine your “free” or bioavailable hormone levels. The answers will guide you & your doctor towards the appropriate saliva test for each identifiable imbalance.

  • Read carefully through the list of symptoms in each group, and put a check mark next to each symptom that you have. (If you check off the same symptom in more than one group, that’s fine.)
  • Go back and count the check marks in each group. In any group where you have two or more symptoms checked off, there’s a good chance that you 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.)

Print this survey out and bring this to your next naturopathic visit.

Selecting two or more symptoms from the above group may indicate an imbalance, and diagnosis and treatment should be done under the supervision of your naturopathic doctor.

SYMPTOM GROUP 1
PMS Insomnia
Early miscarriage Painful and/or lumpy breasts
Unexplained weight gain Cyclical headaches
Anxiety Infertility
TOTAL BOXES CHECKED

 

SYMPTOM GROUP 2
Vaginal dryness Night sweats
Painful intercourse Memory problems
Bladder infections Lethargic depression
Hot flashes
TOTAL BOXES CHECKED

 

SYMPTOM GROUP 3
Puffiness and bloating Cervical dysplasia (abnormal pap smear)
Rapid weight gain Breast tenderness
Mood swings Heavy bleeding
Anxious depression Migraine headaches
Insomnia Foggy thinking
Red flush on face Gallbladder problems
Weepines
TOTAL BOXES CHECKED

 

SYMPTOM GROUP 4
A combination of the symptoms in #1 and #3
TOTAL BOXES CHECKED

 

SYMPTOM GROUP 5
Acne Polycystic ovary syndrome (PCOS)
Excessive hair on the face and arms Hypoglycemia and/or unstable blood sugar
Thinning hair on the head Infertility
Ovarian cysts Mid-cycle pain
TOTAL BOXES CHECKED

 

SYMPTOM GROUP 6
Debilitating fatigue Unstable blood sugar
Foggy thinking Low blood pressure
Thin and/or dry skin Intolerance to exercise
Brown spots on face
TOTAL BOXES CHECKED

Selecting two or more symptoms from the above group may indicate an imbalance, and diagnosis and treatment should be done under the supervision of your naturopathic doctor.

Group 1: Progesterone Deficiency

Recommendation: Saliva testing for progesterone & estradiol

Group 2: Estrogen Deficiency

Recommendation: Saliva testing for estradiol

Group 3: Excess Estrogen

Recommendation: Saliva testing for all estrogens & progesterone.

Group 4: Estrogen Dominance

Recommendation: Saliva testing for all estrogens & progesterone.

Group 5: Androgen Excess

Recommendation: Saliva testing for all estrogens, progesterone,testosterone, and DHEA.

Group 6: Cortisol or Adrenal Deficiency

Recommendation: Saliva testing- “Adrenal Stress Index” to examine cortisol rhythm and other adrenal hormones.