| The following
is a checklist of symptoms associated with changes in
male hormones.
Print the page out to see if you need help. Score your symptoms 0 for no
problem to 3 for severe problem. After completing
a 4-week , 12 weeks & 26 week program, re-evaluate your symptoms for comparison,
to monitor improvements and allow fine tuning of treatment.
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| Symptom Score 3 for severe problem,
down to 0 for no problem | 0-3 score pre treatment | 0-3 score @ 4 weeks | 0-3 score @ 12 weeks | 0-3 score @ 26 weeks |
| Loss of Motivation (drive) | |
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| Loss of Sex Drive (libido) | |
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| Irritability (grumpiness) | |
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| Anxiety levels | |
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| Procrastination | |
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| Depression | |
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| Problems handling stress | |
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| Fatigue | |
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| Needs daytime sleeps weekends | |
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| Frequency of Spontaneous erections | |
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| Loss of Quality of Erections | |
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| Reduced Frequency of Intercourse | |
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| Loss of Muscle Tone | |
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| Increase belly fat/Increase breast size | |
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| Loss of Competitiveness | |
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| Loss of Interest in playing sport/fitness/exercise | |
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| Loss of Body Hair | |
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| Skin becoming fine/frail | |
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| Loss of height | |
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| Falling asleep in front of TV | |
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| Prostate Problems | |
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| Total Score | |
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| Signs/ Pathology Tests | Result pre treatment | Result @ 4 weeks | Result @ 12 weeks | Result @ 26 weeks |
| Free/salivary Testosterone | |
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| PSA | |
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| Cholesterol/HDL | |
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| Digital examination | |
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| BP | |
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| Weight /BMI | |
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| % body fat/muscle | |
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