• DORIKA MAHO®️ -NATURAL WELLNESS YOU DESERVE •
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DM CHIKARA
DM MAMORU
DM MIRYOKU
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Contact Us
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Shop
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DM CHIKARA
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1. Have you ever had any unstable emotion issues? (e.g. nervousness, irritability, anxiety, depression, mood swings)
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
2. Do you find yourself lacking in stamina, energy OR muscular strength?
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
3. Are you suffered from joint pain/ muscular ache/ backache OR excessive sweating?
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
4. Do you find yourself decrease in beard growth?
A: Yes (3 points)
B: Maybe (2 points)
C: No (0 point)
5. Do you face erectile problem before/ during sexual activity OR decrease in the number of morning erections?
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
6. Are you satisfied with your sexual activity (e.g. desire, sensation, frequency)?
A:Yes (0 point)
B: Occasionally (2 points)
C: No (3 points)
7. Do you face ejaculation OR orgasm problem before/ during/ after sexual activity?
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
8. How do you rate your erection hardness score?
1: Severe ED (3 points)
2: Moderately ED (2 points)
3: Mild ED (1 point)
4: No ED (0 point)
9. Do you face incomplete bladder emptying (does not feel like empty my bladder all the way) ?
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
10. Do you face frequent urination day or night (have to go again less than 2 hours after finish urinating) ?
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
11. Do you face weak/intermittent urine stream OR straining (have to push to begin urination) / constant urge to urinate (hard to wait when have to urinate) ?
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
12. Do you experience loss of appetite, nausea OR vomiting?
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
13. Do you have dark urine color OR pale stool color/ bloody/ tar-colored stool?
A: Yes (3 points)
B: Occasionally (2 points)
C: No (0 point)
14. Do your skin or eyes appear yellowish (jaundice) OR have occasionally itchy skin ?
A: Yes (3points)
B: Occasionally (2 points)
C: No (0 point)
15. Do you go to sleep easily and sleep (7-8 hours) through the night everyday?
A:Yes (0 point)
B: Occasionally (2 points)
C: No (4 points)
16. Do you get at least 30 minutes of exercise or activity everyday?
A: Yes (0 point)
B: Occasionally (2 points)
C: No (4 points)
17. Do you eat balanced diet every meal?
A: Yes (0 point)
B: Occasionally (2 points)
C: No (4 points)
18. Do you OR parents/ family members have any chronic illness or diseases?
A: Yes (3 points)
B: Maybe (2 points)
C: No (0 point)
19. Are you a smoker/ drinker?
A:Yes (4 points)
B: Occasionally (2 points)
C: No (0 point)
20. How would you describe your working mood?
A: Stressed and tired (4 points)
B: Manageable (1 point)
C: Quite leisurely (0 point)
Total Points :
Points
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