HORMONE BALANCE CHECKLIST

Estrogen Deficiency Symptoms:

□ Hot flashes

□ Night sweats

□ sleep disturbances

□Vaginal dryness/atrophy

□ Dry skin

□ Headaches

□ Memory lapses

□ heart palpitations

□ yeast infections

□ painful intercourse

□ depression

□ low libido

□ bone loss

Estrogen Excess Symptoms:

□ Water retention

□ Heavy, irregular menses

□ Breast swelling and tenderness

□ fatigue

□ craving for sweets

□ weight gain

□ fibrocystic breasts

□ mood swings

□ uterine fibroids

□ low thyroid symptoms

□ nervousness/ anxiety/ irritability

□ hot flashes/night sweats

Progesterone Deficiency Symptoms:

Many of the symptoms of Estrogen Excess, plus:

□ Swollen breasts

□ Weight gain

□ headaches

□ low libido

□ anxiety

□ mood swings

□ irregular menses

□ depression

□ cramping

□ PMS

□ infertility

□ fuzzy thinking

□ acne

□ joint pain

Progesterone Excess Symptoms:

Many of the symptoms of Estrogen Deficiency, plus:

□ Somnolence

□ Gastrointestinal bloating

□ mild depression

□ breast swelling

□ candida exacerbations

Testosterone Deficiency Symptoms:

□ Fatigue, prolonged

□ mental fuzziness

□ Memory problems

□ depression

□ decreased libido

□ blunted motivation

□ muscle weakness

□ a diminished feeling of well being

□ heart palpitations

□ thinning skin

□ bone loss

□ vaginal dryness

□ incontinence

□ general aches/pains

□ fibromyalgia

Testosterone Excess Symptoms:

□ acne

□ male – pattern hair growth

□ deepening of the voice

□ clitoral enlargement

□ irritability/moodiness

□ insomnia

□ loss of scalp hair

Symptoms of Low and High Cortisol (Adrenal Fatigue):

□ fatigue

□ allergies

□ Cravings for sweets

□ irritability

□ chemical sensitivities

□ bone loss

□ anxiety

□ sleep disturbances

□ depression

□ low libido

□ hair loss

□ anxiety

□ elevated triglycerides

□ symptoms of hypothyroidism

□ symptoms of low progesterone

Symptoms of Low Thyroid:

□ fatigue (especially evening)

□ low stamina

□ cold extremities

□ low body temperature

□ low libido

□ headaches

□ dry skin

□ intolerance to cold

□ general aches and pains

□ weight gain

□ depression

□ anxiety

□ scalp hair loss

□ swollen, puffy eyes

□ brittle nails

□ decreased swelling

□ low pulse rate/blood pressure

□ poor concentration

□ memory lapses

□ high cholesterol

□ heart palpitations

□ infertility

□ constipation

□ fibromyalgia

Symptoms of High Thyroid:

□ rapid heart rate

□ diarrhea

□ insomnia

□ weight loss

□ agitation

□ increased sweating

□ dry skin

□ heat intolerance

□ thinning skin

□ hair loss