ADAM (Androgen Deficiency in the Aging Male) Questionnaire Fill out online or download & print to fill out offline. Download & Print Name First Last Number*Age Weight Height Please answer each of the questions below by choosing 'yes' or 'no'.Do you have a decrease in libido (sex drive)? Yes No Do you have a lack of energy? Yes No Do you have a decrease in strength and/or endurance? Yes No Have you lost height? Yes No Have you noticed a decreased “enjoyment of life?” Yes No Are you sad and/or grumpy? Yes No Are your erections less strong? Yes No Have you noticed a recent deterioration in your ability to play sports? Yes No Are you falling asleep after dinner? Yes No Has there been a recent deterioration in your work performance? Yes No The standard ADAM questionnaire consists of 10 ‘yes or no' questions concerning symptoms of androgen deficiency. These ‘yes' or ‘no' questions, though effective at identifying symptoms associated with androgen deficiency, offer no information about the severity of symptoms. We believe this questionnaire will allow our Body SymmetryMD practitioners to more accurately screen for earlier unrecognized androgen deficiency, as well as monitor patients' responses to treatment. Reference: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834355/
