Aging Male Questionnaire

Aging Male Symptoms (AMS) Self-Assessment

This Ageing Males' Symptoms (AMS) questionnaire is a modified version adapted from Lunenfeld B, Gooren L, eds. Textbook of Mens' Health. London: Parthenon Publishing, 2002:34.

Which of the following symptoms apply to you at this time?
Please mark the appropriate box for each symptom.
For symptoms that do not apply, please select "None".

Symptoms None Mild Moderate Severe Extremely Severe
Decline in your feeling of general well-being
(general state of health, subjective feeling)
Joint pain and muscular ache
(lower back pain, joint pain, pain in a limb, general back ache)
Excessive sweating
(unexpected/sudden episodes of sweating, hot flushes independent of strain)
Sleep problems
(difficulty in falling asleep, difficulty in sleeping through, waking up early and feeling tired, poor sleep, sleeplessness)
Increased need for sleep, often feeling tired
Irritability
(feeling aggressive, easily upset about little things, moody)
Nervousness
(inner tension, restlessness, feeling fidgety)

Anxiety
(feeling panicky)
Physical exhaustion/lacking vitality
(general decrease in performance, reduced activity, lacking interest in leisure activities, feeling of getting less done, of achieving less, of having to force oneself to undertake activities)
Decrease in muscular strength
(feeling of weakness)
Depressive mood
(feeling down, sad, on the verge of tears, lack of drive, mood swings, feeling nothing is of any use)
Feeling that you have passed your peak
Feeling burnt out, having hit rock-bottom
Decrease in beard growth
Decrease in ability/frequency to perform sexually
Decrease in the number of morning erections
Decrease in sexual desire/libido
(lacking pleasure in sex, lacking desire for sexual intercourse)

YOUR SCORE:

Total Score Severity of Complaints Suggested Action Required
0 - 26 Negligible No testosterone supplementation required
27 - 36 Moderate No testosterone supplementation required.
Regular exercise regimen, stress control and weight management advised. Baseline total testosterone, PSA and Free Androgen Index (FAI) measurements should be taken at next doctor's visit and kept for future reference.
37 - 49 Serious Investigation of testosterone hormone blood status by medical practitioner strongly recommended - total testosterone, PSA and Free Androgen Index (FAI). AndroForte® Testosterone Cream.
Exclude underlying medical conditions that may be present - depression, excess alcohol, stress, prescription and recreational drugs, anaemia and prostate disease. If blood results indicate low range testosterone a three month trial with AndroForte® can be initiated.
50+ Severe Testosterone supplementation with
AndroForte® Testosterone Cream highly recommended.
Investigation of testosterone hormone blood status by medical practitioner recommended - total testosterone, PSA and Free Androgen Index (FAI). Exclude underlying medical conditions that may be present - depression, excess alcohol, stress, prescription and recreational drugs, anaemia and prostate disease.