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ADAM Questionnaire Explained: How the 10-Question Low Testosterone Screening Works, How It Is Scored and How Accurate It Is
By Ares Men's Health · Updated October 10, 2026
Short answer: The ADAM questionnaire is a 10-question yes/no screening tool for symptoms of low testosterone in men. It counts as positive if you answer yes to the sex-drive question, the erection-strength question, or any three of the other eight. It screens; it does not diagnose. Only blood tests reviewed by a provider can confirm low testosterone.
Key takeaways
ADAM stands for Androgen Deficiency in the Aging Male. It was published by Dr. John Morley and colleagues in 2000.
Ten yes/no questions cover sex drive, energy, strength, mood, erections, sleepiness and work or sports performance.
A positive screen means yes to question 1 (sex drive) or question 7 (erections), or yes to any three other questions.
In the original study it caught 88% of men with low bioavailable testosterone but also flagged 40% of men whose levels were fine (60% specificity).
A positive result is a reason to test, not a diagnosis, and a negative result does not rule out low testosterone.
What is the ADAM questionnaire?
The ADAM questionnaire is a short checklist that asks whether you have the symptoms most often linked to low testosterone. ADAM stands for Androgen Deficiency in the Aging Male. It is also called the ADAM test, the ADAM score or, by many people searching online, the "Adam's test" — though it has nothing to do with anyone named Adam.
It was developed by Dr. John Morley and colleagues in St. Louis as a quick way for a clinician, or a man himself, to decide whether a blood test for testosterone is worth ordering. It takes about a minute, needs no equipment and costs nothing, which is why it is still widely used decades later.
The important word is screening. A screening tool sorts people into "worth looking at" and "probably not." It does not tell you what is wrong, and it cannot replace laboratory testing.
What do the 10 questions ask about?
The questionnaire asks ten yes-or-no questions about changes you may have noticed recently. Rather than reproduce the wording, here is what each one is probing:
Sex drive — have you noticed a decrease in libido?
Energy — do you have a lack of energy?
Strength and endurance — has your physical strength or stamina fallen?
Height — have you lost height?
Enjoyment of life — have you noticed that you enjoy life less?
Mood — are you sad or grumpy?
Erections — are your erections less strong?
Sport and activity — has your ability to play sports or exercise recently declined?
Sleepiness — are you falling asleep after dinner?
Work performance — has your performance at work recently deteriorated?
These are everyday complaints. That is the strength of the tool, and also its weakness: almost every item can have a cause other than testosterone.
How is the ADAM questionnaire scored?
Scoring is simpler than most people expect. The questionnaire counts as positive if you answer yes to question 1 (decreased sex drive) or question 7 (less strong erections), or if you answer yes to any three of the other eight questions.
That means you can screen positive in two ways: through one of the two sexual-function questions on their own, or through a general cluster of symptoms. Note that it is not a sum out of ten; a man who answers yes to nine questions and a man who answers yes to question 1 alone are both simply "positive."
Your answers | Result |
Yes to question 1 (sex drive) | Positive |
Yes to question 7 (erection strength) | Positive |
Yes to any 3 of the other 8 questions | Positive |
Anything else | Negative |
A later research version, the quantitative ADAM (qADAM), assigns a severity score instead of a simple yes or no, but the original positive-or-negative screen remains the version most clinics and online tools use.
How accurate is the ADAM questionnaire?
The original validation study tested the questionnaire in 316 Canadian physicians aged 40 to 62. About one in four of them had low bioavailable testosterone. Against that standard, the questionnaire had 88% sensitivity and 60% specificity.
In plain language, that means:
Sensitivity of 88%: of every 100 men who truly had low bioavailable testosterone, the questionnaire flagged about 88.
Specificity of 60%: of every 100 men whose testosterone was fine, the questionnaire still flagged about 40.
So it is good at not missing men with low testosterone and poor at ruling out men without it. A positive screen therefore raises the odds that low testosterone is present but does not prove it.
Two practical consequences follow. First, never treat a positive result as a diagnosis. Second, a negative result in a man who has persistent, troubling symptoms is not a reason to stop asking questions.
What can cause a positive ADAM result besides low testosterone?
Because the questions are general, many conditions can make you answer yes. Common examples include:
Sleep problems, including obstructive sleep apnea, which causes daytime sleepiness and low energy
Depression, anxiety and chronic stress, which affect mood, drive and work performance
Thyroid disorders and anemia
Diabetes, high blood pressure and heart disease, which can weaken erections
Medications that lower drive or energy
Alcohol use, excess weight and inactivity
This is exactly why a positive screen leads to bloodwork and a conversation, not straight to treatment. If you want the wider picture of tiredness and what to rule out, read our guide to low energy in men.
What should you do after a positive ADAM result?
A positive result is a prompt to check, calmly and properly. A sensible sequence looks like this:
Take it as a signal, not a verdict. Plenty of men with perfectly healthy testosterone also screen positive.
Get a blood test. A provider usually orders total testosterone, often with SHBG and albumin so free testosterone can be estimated, plus other markers. Our guide to the testosterone blood test explains the preparation.
Expect a repeat. Testosterone varies through the day and from day to day, so a low result is usually confirmed before treatment decisions are made.
Review the whole picture. Your provider looks at sleep, weight, medications, mood and other health conditions alongside your numbers.
Decide together. If low testosterone is confirmed and treatment is clinically appropriate, you discuss options; if not, you work out what else deserves attention.
If you want to see how your estimated free testosterone looks once you have lab values, our free testosterone calculator uses the Vermeulen equation. It is educational and not a diagnosis.
What a negative ADAM result does and does not mean
A negative screen means you did not hit the threshold on this particular checklist. It lowers the likelihood of low testosterone but it does not eliminate it, because the questionnaire was designed to be a rough filter rather than a measuring instrument.
If you answered no to most questions but you still feel persistently unwell, talk to a provider anyway. The questionnaire has no questions about brain fog, concentration, body fat, or recovery after exercise, all of which men commonly report.
How to answer the ADAM questionnaire honestly
A screening is only as good as the answers you give it. A few habits make the result more useful:
Think about the last few months, not one bad week. The questions are about recent change.
Answer for you, not for the average man. A decline in drive or energy matters even if you think it is normal for your age.
Do not answer yes just to be thorough, and do not answer no out of embarrassment. A false result either way sends you down the wrong path.
Note anything else you have noticed, such as brain fog or slower recovery, and mention it to your provider.
ADAM compared with other symptom questionnaires
The ADAM is not the only symptom questionnaire in use. The Aging Males' Symptoms (AMS) scale is a longer questionnaire that scores a wider range of complaints, and the International Index of Erectile Function (IIEF-5) focuses narrowly on erectile function and is used when erections are the main concern.
The ADAM stays popular because it is short and quick to score. Whichever questionnaire a clinic uses, the same rule applies: it guides the next step and the blood test decides the answer.
How the ADAM questionnaire is used at Ares Men's Health
At Ares Men's Health in Miami Lakes, the free 60-second Low-T screening on our ADAM screening page is built on the ADAM questionnaire. It is the first step of a labs-first process delivered entirely by secure telehealth anywhere in Florida.
If the screening suggests a fuller evaluation is worthwhile, you book a video visit with Brian Ruiz, APRN, FNP-BC, complete bloodwork at a lab near you, and review the results together. No treatment is offered until your labs and a provider evaluation are complete, and a medical consultation is always required.
You can read how the whole process fits together in our guide to telehealth TRT in Florida, and how age-related testosterone decline is understood in our overview of andropause.
Limits of the ADAM questionnaire
Researchers have noted several limits that are worth keeping in mind:
It was validated in men aged roughly 40 to 62, so it says less about younger or much older men.
It used bioavailable testosterone as its yardstick, and the cut-offs for "low" differ between laboratories and guidelines.
Answers are subjective. The same man might answer differently on a bad week and a good week.
It tells you nothing about the cause of low testosterone, which matters for choosing a safe plan.
None of that makes it useless. It makes it a first step, which is exactly how it is meant to be used.
Frequently asked questions
What does ADAM stand for in the ADAM questionnaire?
ADAM stands for Androgen Deficiency in the Aging Male. It is a symptom checklist for low testosterone, not a test of anything named Adam, although many people search for it as the Adam's test.
How many questions are on the ADAM questionnaire?
There are 10 yes-or-no questions covering sex drive, energy, strength, height, enjoyment of life, mood, erection strength, sports performance, sleepiness after dinner and work performance.
What score is a positive ADAM result?
It is positive if you answer yes to the sex-drive question, yes to the erection-strength question, or yes to any three of the remaining eight questions. It is not a total out of ten.
Can the ADAM questionnaire diagnose low testosterone?
No. It is a screening tool. Only blood tests, interpreted by a provider alongside your symptoms and history, can confirm low testosterone.
How reliable is the ADAM test?
In its original validation it had 88% sensitivity and 60% specificity, so it rarely misses men with low bioavailable testosterone but often flags men whose levels are fine.
Why was I positive on the ADAM test if my testosterone is normal?
The questions cover everyday symptoms that also arise from poor sleep, stress, mood disorders, thyroid problems, diabetes and medications. A positive screen with normal labs simply means the cause lies elsewhere.
At what age is the ADAM questionnaire meant to be used?
It was validated in men aged about 40 to 62 and is generally described as suitable for men over 40. Younger men with symptoms should still speak with a provider rather than rely on the score.
Is there a difference between the ADAM test and the qADAM?
The qADAM, or quantitative ADAM, grades how severe symptoms are using a score instead of a yes-or-no result. The classic ADAM remains the version most commonly used for quick screening.
How long does the ADAM questionnaire take to complete?
About a minute. Our free Low-T screening takes roughly 60 seconds and is private.
What happens after a positive screening at Ares Men's Health?
You can book a telehealth consultation, complete bloodwork near you, and review results with Brian Ruiz, APRN, FNP-BC. Treatment is offered only if your labs and evaluation show it is clinically appropriate.
Talk to a provider
If the ADAM screening points toward low testosterone, the next step is bloodwork and a conversation with a provider, not guesswork. Ares Men's Health offers provider-led, labs-first care by secure telehealth anywhere in Florida.
Take the free 60-second Low-T screening · Book a consultation · Call 754-335-8868 (Mon–Fri 9am–5pm).
Sources and further reading
This article is educational and does not replace a medical consultation. The ADAM questionnaire is a screening tool, not a diagnosis. Individual results vary.
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