Scoring the Quiz:

First of all, let me apologize and say I'm not able to number the checkboxes from 1-30. That would be too easy!  Also, no quiz is perfect.  There are many more questions I might ask in person to better sort through things.

The first 10 questions relate to HPA Axis Dysfunction.  If you have the majority of your checks in these boxes then you likely have a significant cortisol irregularity.  The HPA (hypothalamus-pituitary-adrenal) axis regulates the stress response and has wide-ranging effects in the body. Furthermore, cortisol can go a little "whacky" during perimenopause, so you may have not had an issue when you were younger but now you do and this will affect your transition through perimenopause.

The second 10 questions relate to Thyroid dysfunction.  If you checked mostly these boxes then you may have low thyroid function and/or Hashimoto's disease, a form of autoimmune thyroid disease.  Thyroid can also go out of whack as estrogen and progesterone levels vary either after childbirth or, you guessed it, perimenopause.

The third set of 10 questions relate to perimenopausal symptoms.  If you checked mostly these boxes then you  may be going through perimenopause, which is the 10 year window that occurs prior to menopause, or cessation of your menstrual cycle.

If your checkmarks are all over the place then you likely have a combination of one, two, or three of the above issues which is not uncommon, especially as we get into our mid-40's and beyond.  Keep in mind, these conditions are obviously not the only things that can account for exhaustion, fatigue, weight gain, loss of libido, etc, but in my experience they account for a majority of these issues in most women.  I am available to help women work it all out, including figuring out if there are other underlying causes to their symptoms.

Now that you have maybe a little more of an idea what could be underlying some of your symptoms and fatigue, here are some general guidelines that apply to all three contributors:

Establishing a daily routine to include the following will start setting you up for more balance:

- Go to bed and rise at generally the same time every day (even weekends).

- Let the sunlight hit your eyes as soon as you roll out of bed by going out with the dog or just going outside for a moment.  This helps reset the pineal gland, which affects the HPA axis.

- Eat regular meals and include at least 20g of protein with every meal - a game changer can be getting 30g of protein for breakfast.  I cannot emphasize the importance of this enough, especially as we get older!  And protein does so many things to regulate our metabolism and our hormones.

- Take a good quality multivitamin and include 2g of fish oil per day along with vitamin D. I often recommend a specific cortisol-assisting supplement - you can see it at the bottom of the page.

- GET SLEEP. This can be done with the right hormones, if needed, and ensuring the cortisol level is balanced. Some women need help shutting down those adrenals at night. 

When I work with women I often check their thyroid, as well as functional salivary hormone testing which helps me look at their sex hormones - not just estradiol and progesterone but also DHEA, testosterone, as well as coritisol levels throughout the day.  This helps me hone in on exactly what the issue is so that I can give much more tailored advice and treatment.  I do recommend testing even if you are perimenopausal or menopausal, again, because of the importance of seeing ALL of the hormones mentioned above. I'm aware that The Menopause Society is not in favor of routine testing, but I have seen too many women actually benefit from the testing mentioned above.

We need to stop putting ourselves and our health on the back-burner and live the lives we were meant to.  Even perimenopause should be a more natural transition than our culture is making it.  Let me help you move through these issues to feel more balanced and vital again!

**Did you get something out of taking this quiz? Have constructive feedback? I'm always learning. Let me know by clicking the chat button in the lower righthand corner of the page!**

I am a board-certified holistic family physician who has been practicing for 23 years.  I attended medical school at MCP Hahnemann School of Medicine in Philadelphia, PA, and fulfilled my residency in family medicine in the USAF National Capital Consortium.  I served as a family physician and flight surgeon with the Air Force for 8 years and am a combat veteran.  After I got out of the service (and was fatigued from years of service and also from years of undiagnosed hypothyroidism), I became interested in more integrative approaches to medicine. Thus began my journey to my own healing and learning about functional and Ayurvedic medicine.  I studied for 4 years at the California College of Ayurvedic Medicine,  certified as a Clinical Ayurvedic Specialist.  In addition, I have done training with the Institute for Functional Medicine and am certified with Dr. Aviva Romm's Functional & Integrative Medicine Training Program.  I am also a proud member of the Menopause Society. I like to meet people where they are and take an uncomplicated approach. I believe the most therapeutic approach is often the most elegant and doesn't need to involve extensive testing or prescribing of exorbitant amounts of supplements.

I see patients in NV, AZ, PA, and CA but even if you are not in those states and have questions please reach out to me!