Step 1- CheckStep 1 of 425%This form takes approximately 10 minutes to complete. We will then send you a personalised report by email.Your Information*This information is needed because experiences vary according to geography, age, height, and body fat.Where do you live?*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweDate of birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Height*Please use this tool to convert feet and inches to centimetres.Weight*Please use this tool to convert stones and pounds to kilograms.Diet This information is needed because hormone levels can vary in individuals according to diet (and the use of some dietary supplements). Never Rarely Sometimes Frequently Daily A LotAlcohol* Never Rarely Sometimes Frequently Daily A LotCaffeine* Never Rarely Sometimes Frequently Daily A LotDairy products (milk, yogurt, cheese, eggs)* Never Rarely Sometimes Frequently Daily A LotPlenty of fresh fruit and vegetables* Never Rarely Sometimes Frequently Daily A LotMeat* Never Rarely Sometimes Frequently Daily A LotProcessed Foods* Never Rarely Sometimes Frequently Daily A LotSugary foods/drinks* Never Rarely Sometimes Frequently Daily A LotWater* Never Rarely Sometimes Frequently Daily A LotIf you take any nutritional supplements, herbal remedies, or vitamin pills, please list them hereHormones / Medication:This information is needed because hormone levels can vary in individuals according to reproductive physiology, the menstrual cycle, and medications.Do you have a functioning uterus (womb) and ovaries?* Yes I have a womb and one ovary I have an ovary/ ovaries only I have a womb only I used to, but not anymore No I don'tMenstruation Status* Not started having periods yet but expect to… Menstruating (without contraceptive medication/device) Menstruating (with contraceptive medication/device) Perimenopause (going through the change but not yet 12 months without menstruation) Menopause (at least 12 months without menstruation) Not menstruating due to removal of womb only Not menstruating due to pregnancy/ breast feeding Not menstruating due to health issue/ exercise level/ being underweight Not menstruating due to contraceptive medication/device Not menstruating due to testosterone hormone therapyHow regular is your menstrual cycle?*N/ARegular (between 21-35 days in length)Regular (over 35 days in length)Irregular (but generally between 21-35 days in length)Irregular (but generally over 35 days in length)Are you currently using any hormonal medications? Combined oral contraceptive pill (oestrogen & progesterone) Mini contraceptive pill (progesterone only) Contraceptive implant under skin Contraceptive patch Contraceptive injection Contraceptive vaginal ring Hormonal IUS (Intrauterine System) e.g. Mirena (N.B. the copper IUD- 'the coil'- is NOT hormonal) Oestrogen pills hormone therapy Oestrogen patch/ gel hormone therapy Oestrogen injection hormone therapy Anti-androgen hormone therapy (all types) Testosterone hormone therapy (all types) Thyroxine (for underactive thyroid gland/ hypothyroidism) Not applicable/ not within the last monthAre you currently using any hormonal medications? Oestrogen pills hormone therapy Oestrogen patch/ gel hormone therapy Oestrogen injection hormone therapy Anti-androgen hormone therapy (all types) Testosterone hormone therapy (all types) Thyroxine (for underactive thyroid gland/ hypothyroidism) Not applicable/ not within the last monthAre you currently on any other medications?If so, please list them, separated by commasDo you have any allergies?If so, please list them, separated by commas.HealthThis information is needed because hormone levels can be affected by medications, and chronic health issues. The final question is the main part of the symptom checker, your answers will inform your personalised symptom checker report.Do you currently have any of these health conditions? Anaemia Anxiety Asthma Cancer (* see below) Chronic fatigue/M.E. Depression Diabetes- type II Endometriosis Epilepsy Thyroid (over/under active) Irritable Bowel Syndrome Migraine Polycystic Ovary syndrome None of these(* breast, ovarian, womb, vagina, vulva, pituitary, prostate, testicular, or thyroid cancers only)How often have you experienced the following within the last 12 months? Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Abdominal pain (period)* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Abdominal pain (other)* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Anxiety/tension* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Backache* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Bladder urgency* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Bloating/ Constipation* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time) Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Breast tenderness* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Clumsiness* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Diarrhoea* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Difficulty concentrating/ Confusion/ Forgetfulness* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Dizziness* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Dry mouth* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time) Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Excessive sweating/ Poor body temperature control* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Fatigue* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Headache/ migraine* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Irritability* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Low libido* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Low mood/self esteem* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time) Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Muscle and joint pain* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Nausea/vomiting* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Painful lymph nodes* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Passing mucus (in stool)* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Restlessness/ Pins and needles* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Sensitivity to light, loud noise, alcohol or certain foods* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time) Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Shortness of breath/ wheezing/ asthma* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Sleep problems* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Sore throat* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Suicidal thoughts* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Tearful* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Trembling or shaking* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Visual/ sensory/ speech problems* Not in the past 12 months Rarely (approx. 1-5 times) Sometimes (approx. 6-11 times) Monthly (approx. 12 cyclical times) Frequently (12-24 times) Chronically (25 + times) On-going (for at least half of the time)Email Address* Insert email address to receive your personalised health report Please tick this box if you would like to receive our quarterly newsletter, full of tips and tricks for managing your healthΔ
