What is the ADAM used for?

The ADAM is a brief screening questionnaire used to identify aging men whose symptoms may reflect low testosterone, or androgen deficiency. It flags candidates for further evaluation, prompting clinicians to consider laboratory testing. It supports clinical decision-making and does not, on its own, diagnose hypogonadism or confirm a testosterone level.

How many questions are on the ADAM?

The ADAM has 10 questions, each answered yes or no. The items ask about libido, energy, physical strength, mood, enjoyment of life, and sexual function. Because it is short and simple, patients typically complete it in a few minutes without any special instruction or clinical supervision during administration.

What counts as a positive ADAM screen?

A screen is positive when a man answers yes to the question about decreased libido or the question about weaker erections, or yes to any three of the remaining questions. A positive result suggests further assessment may be warranted rather than confirming a diagnosis of low testosterone.

Is the ADAM a diagnostic test?

No. The ADAM is a screening tool, not a diagnostic test. It is sensitive but has limited specificity, so many men who screen positive have normal testosterone. Diagnosis of androgen deficiency requires morning serum testosterone measurement and clinical correlation, interpreted alongside the patient's full history and presentation.

Who developed the ADAM questionnaire?

The ADAM was developed by John Morley and colleagues at Saint Louis University and validated in a study published in Metabolism in 2000. It was designed as a simple, low-burden way to screen aging men for symptoms associated with declining testosterone in everyday clinical practice.

Can the ADAM be used to track symptoms over time?

Yes. Although it produces a positive or negative result rather than a graded score, re-administering the ADAM at intervals lets clinicians observe how a patient's reported symptoms change. In Zentake you can re-send it on a schedule and review responses across visits to support ongoing follow-up.

ADAM Low Testosterone Questionnaire | Template & auto-scoring

The Androgen Deficiency in the Aging Male (ADAM) questionnaire is a 10-item yes/no screening tool that flags symptoms commonly associated with low testosterone in aging men. Developed by Morley and colleagues in 2000, it asks about libido, energy, strength, mood, and sexual function to identify men who may benefit from further hormonal evaluation.

Why healthcare providers use the ADAM

Fast symptom screening. Ten short questions help identify men whose symptoms may reflect androgen deficiency in a few minutes.
Low patient burden. The yes/no format is easy to complete and needs no special training or equipment to administer.
Prompts targeted testing. A positive screen can guide clinical decision-making about whether to order a morning serum testosterone level.
Structured documentation. Recording symptoms in a consistent format supports follow-up conversations and comparison over time.

Which settings use the ADAM?

Primary care clinics. Providers use it to screen older men who report fatigue, low libido, or reduced vitality.
Men's health and urology practices. Clinicians use it alongside a broader workup for sexual and hormonal concerns.
Endocrinology clinics. Specialists use it to organize symptom review when evaluating suspected hypogonadism.
Telehealth services. The brief format works well for remote intake before a virtual visit.

What does the ADAM measure?

The ADAM captures self-reported symptoms that can accompany declining testosterone. Rather than producing a numeric total, it asks about several areas of daily function and well-being, with two questions treated as key symptom items. The questions span the following domains.

Sexual function. Changes in libido and the strength of erections.
Energy and physical strength. Loss of energy, reduced strength or endurance, and diminished ability in sports or work.
Mood and enjoyment. Sadness or irritability, reduced enjoyment of life, and falling asleep after dinner.

Scoring the ADAM

Number of items: 10 questions.
Per-item scale: each item is answered yes or no.
Total score range: the ADAM does not produce a summed total; it yields a positive or negative screen based on the pattern of responses.
Score direction: a positive screen indicates a higher likelihood of symptoms linked to androgen deficiency.

The ADAM is a screening aid, not a diagnostic test. It is sensitive but not highly specific, so a positive result guides clinical decision-making rather than confirming low testosterone. Diagnosis requires laboratory confirmation and clinical correlation, and results should always be interpreted in the context of the full presentation.

The ADAM does not use graded severity bands. The published cutoff for a positive screen is a yes answer to the question about decreased libido or the question about weaker erections, or a yes answer to any three of the remaining questions.

Score	Interpretation	Suggested next step
Positive screen	Symptom pattern consistent with possible androgen deficiency	Consider further assessment
Negative screen	Symptom pattern does not meet the screening threshold	Monitor

Best practices for administration

Explain the purpose. Let patients know the questionnaire screens for symptoms that can accompany low testosterone.
Offer privacy. Several questions are sensitive, so allow men to complete it discreetly before the visit.
Pair with laboratory testing. Use a positive screen as a prompt to consider a morning serum testosterone measurement.
Consider other causes. Fatigue, low mood, and reduced libido have many explanations, so review the broader picture.
Re-administer over time. Repeating the screen can help track symptom change during ongoing follow-up.

How Zentake helps with the ADAM

Automatic scoring. Zentake determines the screen result on submit, so there is no hand-tallying of responses.
Longitudinal tracking. Re-send the ADAM on a schedule and view how symptoms change over time.
Before the visit. Patients at primary care practices complete the screen from home on any device, ready before the appointment.
HIPAA compliant. Responses are encrypted, and a signed BAA is included on every plan.

References

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. This is the original validation study, reporting the 10-item format and the positive-screen criteria.

Subsequent studies, including work by Mohamed and colleagues on the quantitative ADAM, have examined the questionnaire's sensitivity and specificity for detecting biochemical androgen deficiency and have consistently described it as a sensitive but low-specificity screen.

Last updated: August 2026.

ADAM Low Testosterone Questionnaire