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Female Estrogen Dominance Quiz

Select the severity of symptoms occurring presently or in the past 6 months.

Estrogen Dominance - Step 1 of 2

Do you have moderate to severe breast tenderness?

Yes
No

Do you have difficulty losing weight?

Yes
No

Do you have increased abdominal or hip fat?

Yes
No

Do you have trouble sleeping?

Yes
No

Do you suffer from anxiety or panic attacks?

Yes
No

Do you get premenstrual mood swings?

Yes
No

Do you get menstrual migraines?

Yes
No

Do you have heavy periods with or withour clotting?

Yes
No

Do you have uterine fibroids?

Yes
No

Do you have fibrocystic breast?

Yes
No

Have you had problems with infertility?

Yes
No

Have you had two or more miscarriages?

Yes
No

First Name *

Last Name *

Email *

Phone *

What state do you reside in? *

Primary Health Concern *

I agree the quiz results are for informational purposes only and not designed to diagnose or treat my specific conditions. I consent to be added to the Rose Wellness free newsletter and be contacted by them.

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Location

2944 Hunter Mill Rd,

Suite 101

Oakton, VA 22124

Tel:(833)ROSEWEL

Fax: (571)210-4099

Office Hours

Monday to Thursday: 8.30 am – 3.30 pm
Friday : 8.30 am – 12.30 pm

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