ADAM questionnaire about symptoms of low testosterone (Androgen Deficiency in the Aging Male)
This basic questionnaire can be very useful for men to describe the kind and severity of their low testosterone symptoms.
Name
First Name
Last Name
Email
example@example.com
1. Do you have a decrease in libido (sex drive)?
*
Yes
No
2. Do you have a lack of energy?
*
Yes
No
3. Do you have a decrease in strength and/or endurance?
*
Yes
No
4. Have you lost height?
*
Yes
No
5. Have you noticed a decreased "enjoyment of life"
*
Yes
No
6. Are you sad and/or grumpy?
*
Yes
No
7. Are your erections less strong?
*
Yes
No
8. Have you noticed a recent deterioration in your ability to Yes No play sports?
*
Yes
No
9. Are you falling asleep after dinner?
*
Yes
No
10. Has there been a recent deterioration in your work Yes No performance?
*
Yes
No
If you Answer Yes to number 1 or 7 or if you answer Yes to more than 3 questions, you may have low Testosterone.
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