Name & Surname
For each statement that applies to you, enter a ' X '.
1.
Insomnia?
2.
Low energy in morning?
3.
Increased body fat, especially around the middle?
4.
Less muscle strength?
5.
Hair loss?
6.
Motivation decline?
7.
Do not achieve orgasm anymore?
8.
Fatigue?
9.
Poor memory retention?
10.
Recent onset of snoring?
11.
Belly fat accumulation?
12.
Chest flab (breast area) enlarging?
13.
Erectile dysfunction?
14.
Cholesterol elevation recent?
15.
Enlarged prostate?
16.
Diabetes?
17.
Weak erections?
18.
Joints ache?
19.
Losing hair quickly?
20.
Decline in libido (sex drive)?
21.
Recent deterioration in work performance?
22.
Often more irritable than before?
