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Hormone Therapy Assessment Quiz

This assessment quiz was designed to ask questions about hormone use and provide up-to-date information on a variety of treatment options.

By answering each of the questions, you will be provided with quality educational feedback. This assessment assumes you are currently using or considering hormone therapy

  • As with all medical decisions, you and your doctor need to weigh the risks and benefits in light of your own situation.
  • Rest assured, no record will be kept of your self assessment
 
 
HRT Assessment Tool:
 

Symptoms:

Do you have hot flashes despite oral hormone use?
Yes
No
Do you have libido/diminished sexual drive problems?
Yes
No
Do you have night sweats?
Yes
No
Do you have sleep disturbances?
Yes
No
Do you have mood disturbances?
Yes
No
Do you have headaches during oral hormone use?
Yes
No
 

Medical Concerns:

Do you have elevated triglycerides?
Yes
No
Are you concerned about heart disease or were you told you were at risk for heart disease?
Yes
No
Do you take medicines called ‘proton pump inhibitors’ such as Nexium, Omeprazole, Prevacid or Prilosec?
Yes
No
 

Lifestyle Concerns:

Do you have trouble remembering to take your oral hormone therapy?
Yes
No
Do you skip dosages of oral hormone therapy?
Yes
No
Are you concerned about the total dose of estrogen in your hormone therapy?
Yes
No
Are you pleased with your current hormone therapy?
Yes
No
Have you used a patch before (for example: birth control patch, smoking cessation patch, sea-sickness patch)?
Yes
No
Have you used progesterone cream?
Yes
No
Are you tired of taking your hormone therapy daily?
Yes
No
Have you had a hysterectomy?
Yes
No