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Screening questionnaire

Low Testosterone Quiz

The ADAM questionnaire is a ten-item screening instrument published in 2000, with 88% sensitivity and 60% specificity in its validation study. That second figure is the one worth holding on to: about four in ten men without low bioavailable testosterone still screen positive. It is a screen, not a diagnosis, and only a blood test measures testosterone.

Last reviewed: September 21, 2026

The questionnaire itself is not reproduced here yet. The instrument is the ADAM questionnaire (Morley et al., Metabolism 2000;49(9):1239–42). Its ten items are the authors’ own wording, and a published translation of it records that its researchers proceeded only after obtaining permission from the instrument’s author. Prof. Peptide is not republishing the items until that question is settled.

What can be stated without reproducing anything is how it is scored, which is a fact about the instrument rather than part of it: the questionnaire has ten yes-or-no items, and the published rule counts a result as positive on a “yes” to item 1, or a “yes” to item 7, or a “yes” to any three of the remaining eight.

In the validation study it showed 88% sensitivity and 60% specificity in 316 men aged 40 to 62 — meaning roughly four in ten men without low bioavailable testosterone still screened positive. It is a screening instrument and not a diagnosis, and no questionnaire replaces a blood test.

How the questionnaire is scored

The instrument is the ADAM (Androgen Deficiency in Aging Males) questionnaire, published by Morley, Charlton, Patrick, et al. in 2000. It has ten yes-or-no items. The published scoring rule counts a result as positive on a “yes” to item 1, or a “yes” to item 7, or a “yes” to any three of the remaining eight items — a rule about how the instrument is scored, stated here as a fact about the paper, not as a description of anyone’s own answers.

The paper validated that rule against bioavailable testosterone measured by blood test in 316 men aged 40 to 62. Comparing the questionnaire’s call against each man’s actual blood result, the rule showed 88% sensitivity and 60% specificity — it correctly flagged 88% of the men who did have low bioavailable testosterone, and correctly cleared 60% of the men who did not. The other side of that second figure is the one worth sitting with: roughly four in ten men without low bioavailable testosterone still scored positive on this questionnaire in the validation sample.

A screening result, not a diagnosis

A positive result here means the answers match the published rule’s definition of a positive screen — nothing more. The Endocrine Society’s clinical practice guideline on testosterone therapy (Bhasin et al., 2018) states that diagnosing hypogonadism requires both symptoms and signs consistent with testosterone deficiency and unequivocally and consistently low serum testosterone, confirmed by measuring an early-morning, fasting total testosterone concentration on at least two separate occasions. A ten-item questionnaire answers neither half of that condition, and this page does not attempt to.

What a positive screen doesn’t show

It doesn’t show a testosterone level — the questionnaire never measures one. It doesn’t rule in hypogonadism, and at 60% specificity it frequently doesn’t rule anything in correctly at all: in the validation sample, a positive screen was wrong more often than one time in three. And it doesn’t stand in for the blood test the diagnostic guideline actually requires, taken on two separate mornings and read together with symptoms by a clinician. What the questionnaire reports is only ever that: the published rule’s own call on a set of answers.

FAQ

What does a positive result on this questionnaire mean?
It means the answers match the published scoring rule's definition of a positive screen — a 'yes' to item 1, or a 'yes' to item 7, or a 'yes' to any three of the remaining eight items. That is a fact about how the instrument is scored, not a statement about the person answering it. The questionnaire's own validation study found this rule identifies 88% of men who had low bioavailable testosterone by blood test, but also flags 40% of men who did not — a screening result, not a diagnosis.
Can this questionnaire diagnose low testosterone?
No. It is a screening instrument, not a diagnostic one, and its own published validation makes that distinction necessary: at 60% specificity, roughly four in ten men without low bioavailable testosterone still score positive. The Endocrine Society's clinical practice guideline on testosterone therapy states that a diagnosis of hypogonadism requires both symptoms and signs consistent with testosterone deficiency AND unequivocally and consistently low serum testosterone, confirmed on at least two separate early-morning, fasting blood measurements. A questionnaire answers neither half of that on its own.
What did the original validation study measure?
Morley et al. (Metabolism, 2000) tested the ten-item questionnaire against bioavailable testosterone measured by blood test in 316 men aged 40 to 62. Comparing the questionnaire's positive/negative call against each man's actual bioavailable testosterone result, the published rule showed 88% sensitivity (correctly flagging men who did have low bioavailable testosterone) and 60% specificity (correctly clearing men who did not).
If the result is positive, what's the next step?
The published guideline for diagnosing testosterone deficiency specifies blood testing, not a repeat of this or any other questionnaire: an early-morning, fasting total testosterone measurement, confirmed by a second such measurement on a separate occasion, interpreted alongside symptoms and signs by a clinician. This page does not perform that test or interpret its result.

References

  1. 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. https://pubmed.ncbi.nlm.nih.gov/11016912/
  2. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. https://pubmed.ncbi.nlm.nih.gov/29562364/

For a blood test’s own free and bioavailable testosterone figures, see the free testosterone calculator.