Ayurvedic Health Assessment

Your Body Type

<a href="https://medhyaherbals.com/vata-imbalance/">Vata</a>

<a href="https://medhyaherbals.com/vata-pitta-dosha/">Vata Pitta</a>

Vata <a href="https://medhyaherbals.com/kapha-imbalance/">Kapha</a>

Vata <a href="https://medhyaherbals.com/pitta-imbalance/">Pitta</a> Kapha

Please select your gender.*

Female

Male

Please select your age group. Your health assessment will be based on your age group.*

This checks the age group of an individual and directs them to age specific questionnaire.

Are you experiencing Headaches or Migraine?*

No headaches.

Yes, but my headaches are manageable. Sometimes or less than two times a week.

I get frequent (3-4 times a week) headaches that are mild to moderate in intensity. OR I get infrequent (once or twice a month) but severe headaches.

I get debilitating headaches more than two times a month. It usually takes me a few days to recover from such headaches.

Please select option(s) that best describes your headaches or migraines.*

Throbbing pain in lower back portion of head. I get sensitive to noise. Most often my headaches are triggered by stress, or lack of sleep, or hunger.

Intense pain is felt in the temple region of head. I get sensitive to light and noise. Often get nausea and vomiting.

Most of the time my headache is in the frontal portion of the head. It is often triggered by congestion and allergies.

Are you experiencing Hot Flashes and or Night Sweats?*

Sudden feeling of warmth in your upper body followed by chills, sweating, and palpitations

No headaches.

Mild or Occasional. 1-2 times a month. My hot flashes or night sweats often get triggered by excessive stress, heat, or food.

Uncomfortable hot flashes or night sweats. Several times (3-4) times in a week.

Very disturbing hot flashes or night sweats. Many times in a day and or night.

Have you observed increased urination frequency, or feel frequent and urgent sense of urination, or experiencing Urinary InContinence (leakage accidents) ?*

I have normal urination pattern.

I have occasional urgency to urinate or more frequent urination.

I am facing increase in urinary frequency, noticeable sense of urgency, or occasional leakage.

I am facing frequent leakages or sudden need to urinate on regular basis.

Did you experience microbial Infections such as UTI, Vaginitis, Stomach Infection (Gastroenteritis), Ear Infection, or Respiratory Tract Infection (RTI) in the past 6 Months?*

None

No more than one infection case. Also, Infection went away with changes in diet and lifestyle and or medication.

I experienced Infections more than once with difficulty in subsiding off. Accompanying symptoms of cold, cough, or high fever were there too. High inflammation and pain is observed during Infection.

I am facing recurring or persistent Infections with accompanying symptoms of cold, cough, and fever. Severe inflammation and pain is observed.

Please share details of the infections that you suffered from.

For example: I struggled with recurring UTI or Stomach Infection.

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Are you experiencing any dryness of skin and scalp or wrinkling of the Skin?*

I have my usual moisture levels. My skin is yet supple and soft.

I have occasional dryness of skin and or dandruff that gets aggravated due to food or seasonal changes. It is easily fixed by removing the cause or oleation with cream or oil. I do not have wrinkles or loose skin.

I have recurring dryness of skin and or dandruff. It gets triggered by even mild change in external factors. It is difficult to moisturise with just oil or creams. I have Wrinkles and or Dandruff at moderate levels.

I have chronic Dandruff. I am facing itching, dryness, and cracking of skin and scalp on a regular basis. I have visible Wrinkles and or sagging skin.

Do you have muscle aches and pains? *

Not at all! My muscles are comfortable and supple.

I have mild or occasional muscular pain, which is unrelated to exercise or any physical exertion.

I get easily fatigued or have sore muscles after physical work. I have moderate aching in my muscles. It is even more during the day from 2 – 6 AM or PM.

I have severe pains in the muscles, am facing tender spots and weakness. OR I have fibromyalgia diagnosis.

How is your Sexual Interest or Libido?*

I have normal sex drive.

Less! My interest in sex is reduced than it used to be.

Much less interest! It is difficult to get sexual arousal now than how it used to be in the past.

My sex drive has completely disappeared.

How is your memory, ability to focus, and retention? *

Good Memory and focus, No Decline.

A little low! My memory is not the same as it used to be. My attention often wanders away.

I frequently and quickly forget so that I have to make notes! I have difficulty in recalling names. I feel my memory is fuzzy.

I have difficulty in remembering most of the things. I often feel sluggish and foggy. It is affecting my work and daily life.

How is the health of your hair? Are you experiencing any hair fall issues or perhaps hair thinning?*

None! My hair is lustrous and healthy as always.

It seems my hair is thinning down and loosing its shine! Or I have occasional episodes of visible but moderate amount of Hair Fall.

I have significant hair thinning, dry, and dull hair. Or I am facing recurring episodes of hair fall, which get aggravated by external factors of season, travel, or change in diet. Each time moderate amount of hair fall is observed.

I am loosing hair like anything! Baldness seems to begin and I have empty patches of scalp on my head. I have extensive hair loss on regular basis.

Do you have stiffness or pain in joints such as shoulders and knees?*

Not at all! My joints are supple and without discomfort.

I have mild soreness or cracking of joints that comes and goes.

I have recurring soreness or aches of moderate intensity in joints. It is even more in early morning times or early evening times from 2 – 6 AM or PM.

I have severe and persistence pain in the joints. or I have osteoarthritis diagnosis.

Do you have pain in your back or lower lumbar region of your spine?*

Not at all! My back is supple and without discomfort.

I have light or occasional back pain, specifically when bending or sitting on the floor.

I have recurring (comes and goes) back pain with moderate intensity. It is affecting my daily activities.

I have severe and chronic back pain that restricts my spinal movement. The pain gets intensified with sitting and standing position and relieved when resting on bed. OR I have been diagnosed with Sciatica.

Are you suffering from joint swelling? Or have a feeling of heaviness especially around the face, thighs, your ankles, or part of legs below the knees? *

None present.

Mild or occasional! Especially early in morning or late in evening times between 6 – 10 AM or PM. Easily subsides off with movement.

Often! It is difficult, painful, and does not subside easily. My weight fluctuates quite a lot during the week. I often feel heavy and clumsy.

I have persistent and painful joint swelling. There is a feeling of heaviness and water retention, specially in my thighs, abdomen, and around the face.

Do you feel fatigued, lacking energy, almost as if you are unable to push yourself through the day? Check one or more appropriate option (s).*

I have good energy as it was in the past.

I have less energy than in the past, but I am able to undertake physically or mentally demanding tasks.

I am tired at least half of the time. I am experiencing frequent energy crashes during the day.

I have a constant feeling of exhaustion and no energy to carry out any tasks. I feel tired in the morning, even after a full night’s sleep.

Do you have any greying or whitening of hair?*

None! My hair still holds its colour and lustre.

I have few strands of grey or white hair.

I have moderate greying of hair with visible patches.

I have significant grey hair all over my body. My hair have lost their colour and lustre.

Is your skin itchy, inflamed, or sensitive? Do you experience Skin Rashes, Eczema, or Acne Eruptions?*

No! My skin is spotless and smooth.

Yes at times! In the last 3 months I had less than 2 episodes of Skin inflammation, Allergies, or Rashes.

Pretty Bad! I sometimes get up to 4 episodes a month when my skin goes red, burns, and is itchy!

I am suffering! My acne and rashes do not seem to be receding. Sometimes, I have them ongoing for multiple days in a row.

Are you suffering from any respiratory congestion, sinusitis, or excess mucus formation?*

No, My breathing is good. My lungs are clear of mucus. I do not face any seasonal allergies.

Yes sometimes! I get runny nose when I get up in the morning. Sudden changes in temperature, fragrances, dust, and pollen often trigger respiratory problem and runny nose.

A lot! My sinusitis and respiratory problems get aggravated early in morning, winter, and spring season. I suffer a lot with each changing season.

Yes, I have chronic mucus and breathing problem. I am suffering from Asthma, or Bronchitis.

How has your weight changed in the past 1 year?*

My weight is nearly stable or I have experienced weight gain of less than 2 Kg.

I have gained weight between 3 – 5 Kg.

I have gained somewhere between 5 – 10 Kg.

I have gained more than 10 Kg.

I had significant weight loss (more than 3 Kg) without any change in diet or physical activity. I am looking frail and concerned about my health.

Choose the Option that best describes your Appetite.*

My appetite is normal.

My appetite is irregular. Often I feel very hungry and other times my stomach feels very heavy.

I get too hungry too often. Irritation and Hypoglycemia follow if I do not eat.

I have low or no appetite. My stomach always feels very heavy and I tend to over salivate.

Choose the options that best describe your food cravings.*

Check what is applicable.

I do not have any specific food cravings.

I crave for dense, fried, hot, and spicy foods such as spicy snacks, and chips.

I crave for dense foods such as dairy (cheese or paneer specifically), eggs, or meat with marrow.

I have intense cravings for sweet, cold, and juicy foods as juices, sweets, and fruits.

Often I crave hot, dry, sour, and spicy foods as spicy crackers.

I crave for sweets, carbohydrates, and fast foods.

I crave for salty foods.

How is your digestion? *

Please check one or more options if applicable.

My digestion is good with no symptoms for most of the time.

My biggest digestive issues relate to heartburn, acid reflux, and high acidity levels after I eat food. And Or I have been diagnosed with GERD, Gastritis, Colitis.

I have frequent belly problems as Indigestion, Bloating, and pain in upper abdomen. My digestion is irregular, sometimes I am constipated and other times I get loose stools. Even a small amount of food causes gas and bloating.

Very poor. I have a constant feeling of heaviness in my belly even without eating food. I am not able to digest the simplest of foods.

How are your stools? Check what is mostly applicable.*

Check what is applicable.

Yellow, dark yellow, no foul smell. Soft and well formed stool that skins at the bottom.

Black coloured without any intake of black coloured or dark food.

Blood in the stools without piles.

Foul smelling stool that sinks at the bottom. Or Presence of Undigested food in the stools.

Dry, Hard, and Dark coloured stool. I often face constipation and flatulence.

Pale yellow, Whitish, Sticky, with Mucus, and Sluggish. Most of the time I get a feeling of incomplete elimination.

Soft, Unformed, Greenish in colour. Often my bowel elimination tends towards Diarrhoea.

How is your body temperature? Do you feel overheated (feeling of more heat than usual) or too cold?*

Usually changes during the day. I feel comfortable, not too cold and not too hot.

I am unable to bear hot temperatures or weathers. I can only withstand hot weather for short duration. Long exposure to the Sun often triggers headaches.

I feel very hot most of the time. Exposure to heat or bright Sun leads to headaches and or restlessness.

I feel cold all the time, specially around the soles and palms.

Choose the Option(s) that best describes your sweat.*

None of the above. My sweating is normal, without any smell.

Sweating irritates your skin and or provokes rashes.

Foul smelling sweat.

Inflamed or Infected sweat glands or Hidradenitits.

No sweating or minimal sweating even when it is very hot.

Excessive Sweating.

Do you have Cysts or Fibroids? *

Check what is applicable.

I do not have any cysts or fibroids.

I have fluid filled Cysts under the skin (Breast, Ovaries, Kidneys, Spine, Epididymis etc.)

I have Fatty cysts under the skin or scalp.

I have Fibroids in the uterus or elsewhere in the body.

I have or had benign lumps or cysts.

I have PCOS – Polycystic Ovaries (Females)

Are you experiencing any vaginal discomforts? *

Please check one or more options if applicable.

None! I have normal lubrication, no pain or discomforts.

I am facing vaginal dryness, thin skinned and often itchy vaginal walls, and or pain during intercourse.

I have a burning sensation, redness, and or inflammation on vaginal walls.

I have experienced fungal or yeast vaginal infections more than once in past three months.

I have persistent and or significant Leucorrhea or vaginal discharge (without blood).

I constantly struggle with vaginal itchiness.

I have foul smelling vaginal discharge.

I often have yellow or green vaginal discharge.

Are you experiencing any Sleeping Difficulties and or Insomnia? *

Please check one or more options if applicable.

Not at all! I sleep like a baby.

Yes, I have difficulty in sleeping in the first place.

I have interrupted sleep. I tend to wake up in the middle of the night, but can go back to sleep after reading something.

I often wake up in the middle with fast heartbeat and have trouble to go back to sleep.

Pretty Bad! I have trouble sleeping on a nightly basis. I can’t sleep or wake up in the middle of the night.

I sleep too much! I do not feel like getting out of the bed on daily basis.

How is your mood and feelings? *

Please check to one or more options if applicable.

I feel calm and settled most of the time. My mood is stable or appropriate to life circumstances.

I feel depressed and low. Crying spells have become usual for me with as much as 3 – 4 episodes every month.

I feel impatient, uncompromising, irritable, and or critical of myself and others. I have frequent Angry Outbursts (Uncontrollable Anger that affected my day or week)

I feel lethargic, sleepy, and demotivated. It is difficult to take on any tasks and finish off.

I feel very anxious most of the time or have panic attacks. Nervousness, Fear, and Loneliness are my most prominent feelings.

I am experiencing frequent Mood Swings that are affecting my relationships. I have sudden feeling of unhappiness or restlessness due to minor stimulation.

I often feel stressed or overwhelmed. I have been under stress for weeks (or months or years).

What does your Menstrual Blood look or feel like?*

Please check to one or more options if applicable.

Bright Red without any spotting, clot free, pain free, and symptom free.

Bright Red, Hot, and Profuse Flow. Menstrual Blood is often foul smelling.

Frothy, Thin, Clotted, Dark and Brownish Menstrual Blood. Light and Scanty flow.

Pale and mucus like menstrual blood accompanied by mucus discharge. Usually heavy and prolonged flow.

Not Applicable.

Please share details of any diagnosed medical condition.

Example – Hypothyroidism, PCOS, Diabetes, or Others

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Please share details of any medication or treatment that you are currently taking.

Example – Diabetes, Thyroid, Hypertension etc.

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Please share details of the usual meal timings and kind of foods you consume. Be specific about the things you may be taking in the middle of the meals.*

Example – I generally eat three home cooked meals at 9 AM, 12 noon, and 7 PM. Fruit or nuts snacks in between meals.

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Please share details of the foods you usually consume. Be Specific on the kind of foods that make major portion of your meals during a week. *

Example – Carrots, Beans, Lentils, Chicken, Fish, Beans, Wheat, Rice etc.

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Please select your current Physical Activity level.*

Low or No Physical Activity – No exercise and no physical work during the day

Moderate Physical Activity – Either you are doing moderate physical work during the day Or exercising at least 3 times a week.

Good Physical Activity – Either good level physical work during the day or exercise at least 5 times a week.

High level Physical Activity – Demanding physical work during the day or exercising all days a week.

Your Weight and Height for BMI Evaluation*

Your Weight in Kg

Your height in cm

Your BMI

0

Your Contact Details

First Name

Last Name

Email Address

Ayurvedic Health Assessment

Ayurvedic Health Assessment

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Thank you for taking Ayurvedic Health Assessment. Here is your health analysis.