SWI: ESTROGEN TEST

ESTROGEN TEST

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Birth of date: Month / Day / Year

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Signs and symtoms


1. I'm losing hair on the top of my head

Never Sometimes Regular Often Constantly


2. I'm getting thin, vertical wringkles above my lips

Never Sometimes Regular Often Constantly


3. My breast are droopy

Never Sometimes Regular Often Constantly


4. My face is too hairy

Never Sometimes Regular Often Constantly


5. My eyes are dry and easily irritated

Never Sometimes Regular Often Constantly


6. I have hot flashes

Never Sometimes Regular Often Constantly


7. I feel tired constantly

Never Sometimes Regular Often Constantly


8. I am depressed

Never Sometimes Regular Often Constantly


9. My menstrual flos is light

Never Sometimes Regular Often Constantly


10. My cycles are too short or too long

Never Sometimes Regular Often Constantly


11. Women without periods: I don't feel like making love no more

Never Sometimes Regular Often Constantly