The ADAM Questionnaire for Low Testosterone

The ADAM (Androgen Deficiency in the Aging Male) questionnaire is a standardized screening tool developed by Dr. John E. Morley and colleagues at the Division of Geriatric Medicine, Saint Louis University School of Medicine. It was first published in the journal Metabolism in 2000 and has since become one of the most widely used screening instruments for identifying men who may have low testosterone.

The original ADAM questionnaire consists of 10 yes/no questions covering key symptom domains associated with androgen deficiency: libido, energy, strength, height, enjoyment of life, sadness, erections, athletic performance, post-dinner sleepiness, and work performance.

A positive screen (answering "yes" to question 1 or 7, or "yes" to any three other questions) indicates the patient should be evaluated further with serum testosterone measurement.

The ADAM questionnaire has been evaluated in multiple clinical studies across different populations. Key findings include:

Sensitivity: Approximately 88% — meaning it correctly identifies about 88 out of 100 men who actually have low testosterone. This high sensitivity makes it effective as a screening tool where the goal is to minimize missed cases.

Specificity: Around 60% — meaning some men who screen positive may have normal testosterone levels. This is by design: a screening tool should err on the side of identifying potential cases for follow-up testing rather than missing them.

The ADAM questionnaire has been validated in populations ranging from community-dwelling older men to patients in primary care settings. It performs best when used as intended — as a first-pass screening tool that identifies candidates for confirmatory blood testing, not as a standalone diagnostic.

Several follow-up studies have confirmed its utility across different ethnic groups and age ranges, though researchers note that specificity can be improved when combined with other clinical indicators like waist circumference and BMI.

Our screener adapts the ADAM questionnaire in two key ways to improve the user experience while maintaining clinical relevance:

Graded responses instead of yes/no: The original ADAM uses binary yes/no answers, which can feel limiting. Our version offers four response levels — "Not at all," "Rarely," "Often," and "Very often" — providing a more nuanced picture of symptom severity. This graded approach follows the methodology used in later validated instruments like the AMS (Aging Males' Symptoms) scale.

Consolidated to 7 core questions: We distilled the original 10 questions into 7 that cover the same clinical domains (energy, cognition, libido, body composition, and mood) without redundancy. Each question maps directly to symptom categories that endocrinologists and urologists evaluate during clinical assessment.

The result is a faster, more user-friendly screening that still covers the fundamental symptom domains used in clinical practice. Your results are presented in three tiers (Mild, Moderate, Strong) to help you understand the overall pattern of your symptoms.

As with the original ADAM test, a positive screening result is a recommendation for further evaluation — not a diagnosis. Blood work remains the gold standard for confirming low testosterone.