The ability to conceive a baby and enjoy a healthy pregnancy depends upon many factors. A critical reason for infertility is lack of hormone balance. The femal sex hormones (estrogen, progesterone & testosterone) along with the thyroid and adrenal hormones are major factors in your ability to become pregnant and maintain a healthy pregnancy.  Nutrient deficiency may also contribute to fertility issues.

This questionnaire lists symptoms commonly found in women suffering from an imbalance of female hormones and/or thyroid hormones. Please read each question carefully and check the box if it applies to you. When you finish, the form will automatically calculate your score.

Do you have premenstrual tenderness?
Do you have premenstrual mood swings?
Do you have premenstrual fluid retention and weight gain?
Do you have migraine headaches?
Do you have severe menstrual cramps?
Do you heavy menses or clotting?
Do you have uterine fibroids?
Do you have fibrocystic breast disease?
Do you have endometriosis?
Do you have have problems with infertility?
Have you had more than one miscarriage?
Do you have decreased libido (sex drive)?
Do you have anxiety or panic attacks?
Do you have fatigue?
Do you have elevated cholesterol?
Do you have difficulty losing weight?
Do you have cold hands and feet?
Are you experiencing hair loss?
Do you have less than one bowel movement per day?
Do you have recurrent sinus infections?
Is your tongue enlarged with teeth indentations?
Is your skin pasty, puffy or pale?
Do you have decreased or excessive body hair?
Is your usual body temperature lower than 98.6 degrees?
Total Score:

Check your scores against the following results key. If your score is:

Below 6 - It is not likely that you have low progesterone and/or low thyroid
Between 7 - 20 - Low progesterone and/or low thyroid are a possibility (hormone imbalance)
Between 21 - 40 - Low progesterone and/or low thyroid are probable (hormone imbalance)
Above 40, Low progesterone and/or low thyroid are very likely (hormone imbalance).  Further evaluation may be warranted.

Find additional information on Infertility and the Wycoff Wellness Center's approach to infertility issues.