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Male Hormones

The male hormone complex is less complicated than the female hormone complex but that doesn't mean it causes any less severe symptoms when it is out of balance.  The sex hormones play major roles in multiple organ systems in your body and when the sex hormones are not at adequate levels it can affect sleep, muscle mass, libido, hair, skin, your mood and a host of other different symptoms in addition to the above.  This quiz is designed to help determine if you could have Male Hormone Dysfunction.  The results are not diagnostic of dysfunction but will help direct you if you should seek further evaluation with a Qualified Medical Professional.

Sincerely,

Jon Skelton, MD

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Past Medical History for Sex Hormone Dysfunction

In this section we will assess your risk for Hormone Dysfunction due to Past Medical History

Question 2 of 21

Do you or a close relative (Father, Grandfather, Brother) have a family history of Prostate of Testicular Cancer?

A

Yes

B

No

Question 3 of 21

Are you currently on any hormone replacement therapy or testosterone boosting supplements?

A

Yes

B

No

Question 4 of 21

Have you had an orchiectomy or been told you have a low sperm count?

A

Yes

B

No

Your Current Symptoms

In this section we will be asking you to rate how often you have symptoms associated with Hormonal Dysfunction. 

Answers will range from 0 which means rare/never to 3 which means nearly daily or more.  Only choose 1 answer.

Question 6 of 21

Urination difficulty or dribbling 

A

0

B

1

C

2

D

3

Question 7 of 21

Frequent urination 

A

0

B

1

C

2

D

3

Question 8 of 21

Mental Fogginess

A

0

B

1

C

2

D

3

Question 9 of 21

Disinterest in sex 

A

0

B

1

C

2

D

3

Question 10 of 21

Inability to concentrate 

A

0

B

1

C

2

D

3

Question 11 of 21

Depression

A

0

B

1

C

2

D

3

Question 12 of 21

Decreased number of spontaneous morning erections 

A

0

B

1

C

2

D

3

Question 13 of 21

Decreased fullness of erections 

A

0

B

1

C

2

D

3

Question 14 of 21

Muscle soreness 

A

0

B

1

C

2

D

3

Question 15 of 21

Decreased physical stamina 

A

0

B

1

C

2

D

3

Question 16 of 21

Unexpected weight gain 

A

0

B

1

C

2

D

3

Question 17 of 21

Increase in fat distribution around chest and hips

A

0

B

1

C

2

D

3

Question 18 of 21

Sweating attacks

A

0

B

1

C

2

D

3

Question 19 of 21

More emotional than in the past

A

0

B

1

C

2

D

3

Question 20 of 21

Pain inside of legs or heels 

A

0

B

1

C

2

D

3

Question 21 of 21

Feeling of incomplete bowel emptying 

A

0

B

1

C

2

D

3

Confirm and Submit