What is your primary and most current sexual health concern?
How long have you been experiencing this issue(s)?
Are you currently taking any medications or supplements?
Do you have any existing medical conditions (e.g., endometriosis, diabetes)?
Are you currently pregnant, trying to conceive, or breastfeeding?
Do you have any history of gynecological issues or surgeries?
Have you experienced any changes in weight, energy, or mood?
Do you smoke or consume alcohol regularly?
Do you experience stress, anxiety, or depression?
Have you had any sexually transmitted infections (STIs) in the past?
Do you have any allergies to medications?
How would you rate your current relationship satisfaction?
Have you tried any treatments or remedies before?
Do you have a family history of reproductive or sexual health issues?
Are you experiencing any pain or discomfort during sexual activity?
Do you have any hormonal imbalances or are you taking hormone replacement therapy?
Are you interested in counseling or therapy as part of your treatment?
Do you have any heart, liver, or kidney issues?
Are you experiencing symptoms like vaginal dryness or hot flashes?
Have you had a recent gynecological exam?
Let's start with the basics
This information helps your doctor determine if you’re eligible for treatment.
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