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Screener · 02

Low-T Symptom Screener

Ten yes/no questions based on the validated ADAM questionnaire1, a screen doctors use to decide who should get a testosterone blood test. It points you toward testing. It cannot tell you whether you have low testosterone.

This is a screen, not a diagnosis. These questions catch most men with low testosterone, but they also flag many men who do not have it. The same symptoms come from thyroid problems, poor sleep, depression, anemia, and common medications. Only a morning blood test read by a clinician can confirm anything.
How you’ve been feeling lately

Answer Yes or No for each. “Decrease,” “less,” and “deterioration” mean compared with a few years ago: your usual self, not a single off day.

1Do you have a decrease in libido or sex drive? Less interest in sex than you had a few years ago.
2Do you have a lack of energy? Persistent low energy, not just the occasional tired day.
3Do you have a decrease in strength and/or endurance? Noticeably weaker, or tiring faster, than you used to be.
4Have you lost height? Measured shorter than in your 20s–30s. Height loss can reflect the bone-density decline linked to low testosterone.
5Have you noticed a decreased enjoyment of life? Things you used to look forward to feel flat.
6Are you sad and/or grumpy? More irritable or low in mood than is usual for you.
7Are your erections less strong? Weaker or less reliable erections than in the past.
8Have you noticed a recent deterioration in your ability to play sports? A clear drop in athletic performance or stamina.
9Are you falling asleep after dinner? Regularly dozing off in the evening when you did not before.
10Has there been a recent deterioration in your work performance? A recent, noticeable drop in focus or output at work.

Please answer all ten questions.

About this screen

These are the ten items of the ADAM questionnaire (Androgen Deficiency in the Aging Male), from Morley et al., Metabolism 2000.1 A screen counts as positive if you answer yes to question 1 (libido) or question 7 (erections), or yes to any three other questions.

In its original study the ADAM screen caught about 88% of men with low testosterone (sensitivity) but cleared only about 60% of men without it (specificity), and specificity is lower in later studies. In plain terms: a negative result is reassuring, a positive result mostly means "worth a blood test." Major guidelines do not use questionnaires alone to diagnose low testosterone.2

Source: Morley JE, et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism. 2000;49(9):1239–42 (PMID 11016912). Diagnostic framing per the Endocrine Society guideline (Bhasin et al., 2018).

Sources

  1. Morley JE, Charlton E, Patrick P, et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism. 2000;49(9):1239–42. DOI · PubMed ↩
  2. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715–44. DOI ↩