At the time of Diagnosis

    Date diagnosed with HA

    Examination / Tests performed at diagnosis of HA

    Physical ExamVaginal Ultrasound (sonography)MRIBone Scan (DXA scan)Progesterone Challenge

    Bloods at diagnosis (if known)

    * if clinical hyperandrogenism

    Attach blood results file (8mb max)

    Anthropometrics at diagnosis


    Physical activity at diagnosis

    Please note down your previous planned and unplanned physical activity, specifying duration. Record intensity levels using L for low intensity, M for moderate & V for vigorous intensity*. Examples of unintentional physical activity include walking or cycling to work or shops, housework and gardening.

    *Low: able to breathe and talk normally
    Moderate: feels somewhat hard. Here are clues that your exercise intensity is at a moderate level:
    • Your breathing quickens, but you're not out of breath.
    • You develop a light sweat after about 10 minutes of activity.
    • You can carry on a conversation, but you can't sing.
    Vigorous: feels challenging. Here are clues that your exercise intensity is at a vigorous level:
    • Your breathing is deep and rapid.
    • You develop a sweat after only a few minutes of activity.
    • You can't say more than a few words without pausing for breath.

    Subjective assessment of stress levels at diagnosis

    How high were your levels of stress at the time of diagnosis with HA? (0- no stress at all; 10- very high levels of stress, impacting on work/relationships)

    Medications

    What medications/ supplements were you taking at the time of diagnosis?

    Diet

    How would you describe your dietary intake at the time of diagnosis? Were you restricting any foods/ food groups or calories?

    Post Diagnosis

    Anthropometrics

    Please record your recent

    Bloods

    Have you had any recent blood tests? Please attach the report, if available. 8mb max file size

    Medications

    What medications/ supplements are you currently taking?

    Other medical conditions

    What (if any) other medical conditions do you currently have?

    Current physical activity levels

    Please note down your usual planned and unplanned physical activity. Record intensity levels using L for low intensity, M for moderate & V for vigorous intensity*. Examples of unintentional physical activity include walking or cycling to work or shops, housework and gardening.

    Subjective assessment of stress levels

    How high are your levels of stress at present? (0- no stress at all; 10- very high levels of stress, impacting on work/relationships)

    The Perceived Stress Scale

    Although some of the questions are similar, there are differences between them and you should treat each one as a separate question. The best approach is to answer fairly quickly. That is, don't try to count up the number of times you felt a particular way; rather indicate the alternative that seems like a reasonable estimate.
    For each question choose from the following alternatives:
    0 – never 1 - almost never 2 – sometimes 3 - fairly often 4 - very often

    1. In the last month, how often have you been upset because of something that happened unexpectedly?
    2. In the last month, how often have you felt that you were unable to control the important things in your life?
    3. In the last month, how often have you felt nervous and stressed?
    4. In the last month, how often have you felt confident about your ability to handle your personal problems?
    5. In the last month, how often have you felt that things were going your way?
    6. In the last month, how often have you found that you could not cope with all the things that you had to do?
    7. In the last month, how often have you been able to control irritations in your life?
    8. In the last month, how often have you felt that you were on top of things?
    9. In the last month, how often have you been angered because of things that happened that were outside of your control?
    10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?

    Diet

    Please record your usual day of eating. Please include all food and drinks. It would be helpful to understand what you usually consume at each meal and snack time.

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