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Male hypogonadism (ADAM)

Hypogonadism is the condition where there are reduced levels of testosterone in the blood. 

The ADAM questionnaire (Androgen Deficiency in the Aging Male) is used internationally to identify symptoms related to testosterone deficiency.

A YES answer to questions 1 or 7, or any 3 of the other questions may indicate a partial deficiency of testosterone secretion.

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Name / Surname: *
Age: *
Do you have a decrease in libido (sex drive)?
*
Do you have a lack of energy?
*
Do you have a decrease in strength and/or endurance?
*
Have you lost height?
*
Have you noticed a decreased "enjoyment of life"?
*
Are you sad and/or grumpy?
*
Are your erections less strong?
*
Have you noticed a recent deterioration in your ability to play sports?
*
Are you falling asleep after dinner?
*
Has there been a recent deterioration in your work performance?
*
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