Testosterone Symptom Screener
Ten yes-or-no questions from the ADAM questionnaire, the screen clinicians use to decide who is worth testing. It does not measure anything — only a blood test can do that.
Question 1 of 10
Do you have a decrease in sex drive?
What it screens for
Low testosterone does not announce itself with one symptom. It shows up as a pattern — drive, energy, strength, mood, sleep and erections drifting together over months, which is exactly why any one of them on its own is a poor guide.
The ADAM questionnaire was built in 2000 to turn that pattern into a yes-or-no question a clinician could ask in a minute: is this man worth a blood test? It is ten items, and two of them — sex drive and erections — carry enough weight to make the screen positive alone.
Symptoms like these overlap heavily with sleep apnoea, depression, thyroid disease, alcohol, medication side effects and simply being tired. The screen cannot separate them; a clinician can.
What a positive screen means
It means the questionnaire has done its job and handed you a reason to get tested. It does not mean your testosterone is low.
Testosterone is diagnosed on blood, not symptoms — and on more than one sample. Levels run highest in the morning and swing day to day, so guidelines ask for a morning total testosterone repeated on a second day before anyone calls it low.
- What the screen is
- Ten yes-or-no symptom questionsADAM, Morley 2000
- Positive when
- Yes to question 1 or 7, or any three answers
- Catches
- 88% of men with low bioavailable testosteronesensitivity
- Also flags
- About 40% of men who do not have it60% specificity
- What settles it
- A morning blood draw, repeated
What it cannot tell you
A screen with 60% specificity is wrong about four times in ten when it says yes. That is not a flaw in the questionnaire — it is what the questionnaire is for. A screen is built to be generous, so that the blood test is what does the ruling out.
- It cannot give you a number, a range, or a trend.
- It cannot tell low testosterone apart from poor sleep, low mood, thyroid disease, heavy drinking or a medication you already take.
- It cannot say whether treatment would help you, or whether it would be safe for you.
- It was validated in middle-aged and older men, so it says little about a man in his twenties.
If your answers worry you, the next step is a provider and a morning blood draw — not a dose.
Where Koves fits
Koves does not prescribe testosterone. If this screen comes back positive, the honest next step is your own clinician and a blood test, and we would rather say that than sell you something adjacent.
Where we can help is the symptom most men actually come in about. Erections that have changed are question 7 on this screen and they are also the thing a PDE5 inhibitor treats directly — and a licensed provider reviewing your visit is the person to work out which of the two you are dealing with.
How this is worked out
- Morley JE, Charlton E, Patrick P, et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism. 2000;49(9):1239–1242 — the study the ten questions and the scoring rule come from, reporting 88% sensitivity and 60% specificity.
- Scoring, as published: the screen is positive on a yes to question 1 (sex drive) or question 7 (erections), or on any three yes answers.
Common questions
Does a positive screen mean I have low testosterone?
No. It means the questionnaire says you are worth testing. Around four in ten men who screen positive turn out to have normal levels, because the screen was deliberately built to be generous — missing someone matters more than testing someone unnecessarily.
Can I be low with a negative screen?
Yes. The screen catches about 88% of men with low bioavailable testosterone, so roughly one in eight is missed. If your symptoms are real and persistent, take them to a clinician regardless of what this page says.
Why does it ask whether I have lost height?
Because testosterone is one of the hormones that maintains bone density, and a measurable loss of height can follow vertebral bone loss. It is one of the ten published items, so it is asked as written rather than edited out.
Does Koves treat low testosterone?
No. Koves does not prescribe testosterone or any testosterone-raising treatment. If this screen is positive, see your own provider for a morning blood test.
Do you keep my answers?
No. The ten answers exist in your browser while the tab is open and are never sent to Koves or anyone else. Opening the sexual health page from here carries nothing with it.
References
A screen is a reason to ask. A blood test is the answer.
See sexual health care