Quantitative Androgen Deficiency in the Aging Male (qADAM)
10-item symptom survey to facilitate the detection of men at risk for androgen (or testosterone) deficiency.
Provided by
EVAL FoundationSymptom Questionnaire
Summary
The qADAM (quantitative Androgen Deficiency in the Aging Male) questionnaire is an enhanced screening tool for potential low testosterone (hypogonadism) that provides a measure of symptom severity. The qADAM is a quantitative modification of the original ADAM questionnaire. The original 10 questions are property of Saint Louis University and were developed by John E. Morley, M.B., B.Ch. The quantitative scoring system was validated and published by Mohamed et al. (2010).
- For the Questions (Original ADAM): Morley, J. E., Charlton, E., Patrick, P., Kaiser, F. E., Cadeau, P., McCready, D., & Perry, H. M., III. (2000). Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism, 49(9), 1239–1242.
- For the Scoring System (qADAM): Mohamed, O., Freundlich, R. E., Dakik, H. K., Grober, E. D., Najari, B., Lipshultz, L. I., & Khera, M. (2010). The quantitative ADAM questionnaire: a new tool in quantifying the severity of hypogonadism. International Journal of Impotence Research, 22(1), 20–24.
The most critical difference is the scoring mechanism:
| Feature | Original ADAM Questionnaire | Quantitative ADAM (qADAM) |
|---|---|---|
| Response | Binary choice (Yes or No) | 5-point Likert Scale |
| Purpose | Simple screening (is the symptom present?) | Screening and quantifying severity (how bad is the symptom?) |
| Scoring | Yes to Q1 (Sex Drive) or Q7* (Erection), OR Yes to any 3 others = Positive Screen (No numerical score) | Total Score from 10 (most symptomatic) to 50 (least symptomatic) |
| Utility | Guides need for a blood test | Guides need for a blood test and helps monitor treatment response. |
*Note: Q6 in the ADAM maps to Q6 in the qADAM
Questions
The qADAM uses the same 10 symptom questions as the original ADAM, but rephrases them slightly to facilitate a graded response. Each question is scored on a 5-point scale, and the score for each question is added together to get the total.
| # | Symptom Area | Standardized Question | Score 1 (Most Symptomatic) | Score 5 (Least Symptomatic) |
|---|---|---|---|---|
| 1 | Libido | How would you rate your libido (sex drive)? | Terrible | Excellent |
| 2 | Energy | How would you rate your energy level? | Terrible | Excellent |
| 3 | Strength/Endurance | How would you rate your strength/endurance? | Terrible | Excellent |
| 4 | Enjoyment | How would you rate your enjoyment of life? | Terrible | Excellent |
| 5 | Mood | How would you rate your happiness level? | Terrible | Excellent |
| 6 | Erections | How strong are your erections? | Extremely Weak | Extremely Strong |
| 7 | Work Performance | How would you rate your work performance over the past 4 weeks? | Terrible | Excellent |
| 8 | Sleep | How often do you fall asleep after dinner? | Every Night | Never |
| 9 | Sports | How would you rate your sports ability over the past 4 weeks? | Terrible | Excellent |
| 10 | Height | How much height have you lost? | 2 inches or more | None - 0.4 inches |
Scoring
The scoring is consistently set up so that a higher score reflects fewer or less severe symptoms (a better outcome).
The standard 5-point Likert scale and corresponding score values are:
| Self-Rating (Example: Libido, Energy, Strength) | Score Value | Interpretation (Symptom Severity) |
|---|---|---|
| Terrible / Extremely Weak | 1 | Maximal Symptoms |
| Poor | 2 | Severe Symptoms |
| Average | 3 | Mild/Average Symptoms |
| Good | 4 | Minimal Symptoms |
| Excellent / Extremely Strong | 5 | No Symptoms |
Interpretation:
Score of 10: Most symptomatic (maximal androgen deficiency suggested).
Score of 50: Least symptomatic (hormonal status likely optimal based on symptoms).
Clinical Utility: The score's value lies in its correlation with serum testosterone levels (demonstrated in studies) and its ability to measure a clinically meaningful improvement (often defined as an increase of ≥ 5 points) after initiating treatment. The qADAM is a powerful tool because it provides a quantitative metric that can be tracked over time, giving doctors a non-invasive way to monitor a patient's quality of life and response to hormonal therapy.
Results include:
- Total Score ##
- You may be experiencing androgen deficiency (If score < 47 OR Q1 is NOT Excellent OR Q6 is NOT Extremely Strong)
- It is unlikely that you are experiencing androgen deficiency (If score > 47)
All questions & possible results
Symptom Questionnaire
1. How would you rate your libido (sex drive)?
Select one option:
- Terrible
- Poor
- Average
- Good
- Excellent
2. How would you rate your energy level?
Select one option:
- Terrible
- Poor
- Average
- Good
- Excellent
3. How would you rate your strength/edurance?
Select one option:
- Terrible
- Poor
- Average
- Good
- Excellent
4. How would you rate your enjoyment of life?
Select one option:
- Terrible
- Poor
- Average
- Good
- Excellent
5. How would you rate your happiness level?
Select one option:
- Terrible
- Poor
- Average
- Good
- Excellent
6. How strong are your erections?
Select one option:
- 1 - Extremely Weak
- 2
- 3
- 4
- 5 - Extremely strong
7. How would you rate your work performance over the past 4 weeks?
Select one option:
- Terrible
- Poor
- Average
- Good
- Excellent
8. How often do you fall asleep after dinner?
Select one option:
- Never
- 1-2/week
- 3-4/week
- 5-6/week
- Every night
9. How would you rate your sports ability over the past 4 weeks?
Select one option:
- Terrible
- Poor
- Average
- Good
- Excellent
10. How much height have you lost?
Select one option:
- 2 inches or more
- 1.5 - 1.9 inches
- 1.0 - 1.4 inches
- 0.5 - 0.9 inches
- none - 0.4 inches
Possible results
You may be experiencing androgen deficiency.
Please discuss your results with your health care provider. Further assessment may still be needed depending on your clinical presentation.
- You are seeing this result because your score includes any one of the following:
- A sex drive that is NOT excellent (Question #1)
- Erections that are NOT extremely strong (Question #6)
- A total score of less than 47 out of 50 points
It is unlikely that you are experiencing androgen deficiency
Please discuss with your health care provider. Further assessment may still be needed depending on your clinical presentation.
Total Score Range on a scale of 10-50 points
A higher score indicates better hormonal health on a scale from 10 to 50 points.
- Score of 10: Most symptomatic (maximal androgen deficiency suggested).
- Score of 50: Least symptomatic (hormonal status likely optimal based on symptoms).
Treatment Monitoring: A common benchmark for "success" in Testosterone Replacement Therapy (TRT) is an increase of greater than or equal to 5 points on the total qADAM score after beginning treatment.
Please discuss with your health care provider. Further assessment may still be needed depending on your clinical presentation.
Medical Disclaimer & Terms of Use
- This assessment is for educational and informational purposes only. It is not a diagnostic tool and does not constitute medical advice, a professional diagnosis, an opinion, or a plan of treatment.
- Consult Your Doctor: The results of this electronic assessment are intended to be a starting point for a conversation with a qualified healthcare professional. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
- No Doctor-Patient Relationship: Use of this electronic tool does not create a doctor-patient relationship between you and the developers of this assessment. If you are experiencing a medical emergency, please stop and call your local emergency services or go to the nearest emergency room immediately.
- Accuracy of Data: By using this tool, you acknowledge that self-reported data is subjective. While this assessment may utilize validated scoring logic, the interpretation of these scores requires clinical context that can only be provided by a licensed medical provider.
Citation
The qADAM is a quantitative modification of the original ADAM questionnaire. The original 10 questions are property of Saint Louis University and were developed by John E. Morley, M.B., B.Ch. The quantitative scoring system was validated and published by Mohamed et al. (2010).
- For the Questions (Original ADAM): Morley, J. E., Charlton, E., Patrick, P., Kaiser, F. E., Cadeau, P., McCready, D., & Perry, H. M., III. (2000). Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism, 49(9), 1239–1242.
- For the Scoring System (qADAM): Mohamed, O., Freundlich, R. E., Dakik, H. K., Grober, E. D., Najari, B., Lipshultz, L. I., & Khera, M. (2010). The quantitative ADAM questionnaire: a new tool in quantifying the severity of hypogonadism. International Journal of Impotence Research, 22(1), 20–24.
Literature
- Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism: Clinical and Experimental, 49(9), 1239–1242. — Morley, J. E., Charlton, E., Patrick, P., Kaiser, F. E., Cadeau, P., McCready, D., & Perry, H. M., III. (2000).
- The quantitative ADAM questionnaire: a new tool in quantifying the severity of hypogonadism. International Journal of Impotence Research, 22(1), 20–24. — Mohamed, O., Freundlich, R. E., Dakik, H. K., Grober, E. D., Najari, B., Lipshultz, L. I., & Khera, M. (2010).
