Do You Have Symptoms of Low Estrogen Levels?

Estrogen Deficiency Symptoms List

Print this form and score the symptoms.

If you score higher than 10 in any hormone excess or deficiency category it is probably worthwhile to do order a hormone saliva test.

Score the Estrogen Deficiency Symptoms that apply to you as:

0 (none)

1 (mild)

2 (moderate)

3 (severe)

Hot flashes ___
Night sweats ___
Vaginal dryness___
Foggy thinking ___
Memory lapses ___
Incontinence ___
Tearful ___
Depressed___
Sleep disturbances___
Heart palpitations___
Bleeding changes___
Bone loss ___          

Total Score:_____

Return from Low Estrogen Levels to Hormone Symptoms