Lower Urinary Tract Symptoms (LUTS), Pain and Discomfort
Have you experienced any symptoms related to urination that have been frequent or bothersome in the last six months, such as difficulty starting to urinate, a weak stream, urgency, or needing to urinate frequently, especially at night?
1 out of 6
Have you experienced any pain or discomfort related to prostate health, such as painful ejaculation, blood in urine or semen, or persistent pain in the back, hips, or thighs?
Have you had any of the following medical tests, procedures, or diagnoses related to prostate health? Please select all that apply.
Previous Prostate Conditions.
PSA (Prostate-Specific Antigen) Test Results
Digital Rectal Exam (DRE) Results
2 out of 6
Prostate Ultrasound or MRI
Have you or any of your family members been diagnosed with the following genetic mutations?
Has your father or brother been diagnosed with prostate cancer?
Have any of your male relatives beyond your immediate family (uncles, grandfathers, cousins) been diagnosed with prostate cancer?
3 out of 6
Have any of your relatives been diagnosed with cancers related to hereditary cancer syndromes that include prostate cancer (e.g., BRCA1/2 mutations, Lynch syndrome)?
Have you worked in an industry known for high exposure to chemicals (e.g., agriculture, painting, manufacturing, or chemical industries)?
Do you live in an area with known high levels of industrial pollution or use of agricultural chemicals?
4 out of 6
Do you frequently use products or engage in activities that involve exposure to chemicals (e.g., heavy use of pesticides in gardening, use of solvents in hobbies)?
Which region best describes your primary residence?
Which of the following best describes your regular diet?
5 out of 6
How would you describe your overall level of physical activity in a typical week?
[Race and Ethnicity]
Please select the racial or ethnic group that best represents you
How would you describe your average stress level and sleep quality over the past year?
6 out of 6
Have you experienced symptoms that may indicate a hormonal imbalance? Symptoms can include fatigue, mood swings, weight gain, or changes in libido