The
Hormone Balance Test
(Based on Dr John Lee’s recommended test)
Find Out if Your Symptoms Are Due to a Hormonal 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)
Where you have checked two or more boxes in any group, it
is likely that you have the hormone imbalance represented
by that group and you should follow up with your doctor
and/or talk to us. A summary of recommendations is provided
for each group.
Hormone
Balance Test for Women
Symptom
Group 1- progesterone deficiency
PMS
Insomnia
Early
miscarriage
Painful
and/or lumpy breasts
Unexplained
weight gain
Cyclical
headaches
Anxiety
Infertility
Total
checkboxes checked:
Recommendations:
change diet, get off synthetic hormones, use progesterone
cream
Symptom
Group 2 - estrogen deficiency
Vaginal
dryness
Night
sweats
Painful
intercourse
Memory
problems
Bladder
infections
Lethargic
depression
Hot
flashes
Total
checkboxes checked:
Recommendations:
change diet, take women’s herbs, take natural estrogen
Symptom
Group 3 - Excess estrogen
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
Weepiness
Total
checkboxes checked:
Recommendations:
get off conventional synthetic hormones
Symptom
Group 4 - Estrogen dominance
A
combination of symptoms in Symptom Group 1 and 3
Total
checkboxes checked:
Recommendations:
increase progesterone to balance estrogen
Symptom
Group 5 – Excess androgens (male hormones)
Acne
Polycystic
ovary syndrome (PCOS)
Excessive hair on face/arms
Hypoglycemia
and/or unstable blood sugar
Thinning
hair on the head
Infertility
Ovarian
cysts
Mid-cycle
pain
Total
checkboxes checked:
Recommendations:
reduce sugar intake and simple carbohydrates
Symptom
Group 6 - Cortisol deficiency
Debilitating
fatigue
Unstable
blood sugar
Foggy
thinking
Low
blood pressure
Thin
and/or dry skin
Intolerance
to exercise
Brown
spots on face
Total
checkboxes checked:
Recommendations:
lower stress levels to relieve tired adrenals