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The Aging Males’ Symptoms (AMS) scale

Do you feel like you have passed your peak? While men do not experience an abrupt decline in sex hormones like women do, many men start to experience bothersome symptoms as they get older, or gain body weight (regardless of age).

The Aging Males' Symptoms scale (AMS) is the most commonly used scale worldwide to measure health-related quality of life and symptoms in aging males.1 It is a self-administered questionnaire that will help you: 2

1) Assess symptoms of aging.

2) Evaluate the severity of your symptoms over time.

3) Measure changes in symptoms before and after testosterone therapy.

The AMS scale is comparable to other scales for aging males or screening instruments for testosterone deficiency, and thus can be used to identify symptomatic men who should be investigated further with a blood test of testosterone.3 It is commonly used as part of the diagnosis of hypogonadism, which requires the presence of characteristic symptoms and signs in combination with low serum levels of testosterone.4-7

The AMS scale is also a valuable tool to measure effects of testosterone treatment on symptom relief over time.12,13

In addition, the AMS scale can help you to “break the ice” at you first doctor visit, as it specifically asks for symptoms that you would not otherwise spell out, but that have an important impact on your wellbeing and quality of life.

On the last page of the questionnaire you will get the option to print out your AMS score. We suggest you do, and bring it to your doctor.

Don't forget to print out results and take them to your doctor on your next visit.

Begin Test
  none mild moderate severe extremly
1.Decline in your feeling of general well-being (general state of health, subjective feeling)
2.Joint pain and muscular ache (lower back pain, joint pain, pain in a limb, general back ache)
3.Excessive sweating(unexpected/sudden episodes of sweating, hot flushes independent of strain)
4.Sleep problems (difficulty in falling asleep, difficulty in sleeping through, waking up early and feeling tired, poor sleep, sleeplessness)
5.Increased need for sleep, often feeling tired
6.Irritability (feeling aggressive, easily upset about little things, moody)
7.Nervousness (inner tension, restlessness, feeling fidgety)
8.Anxiety (feeling panicky)
9.Physical exhaustion / lacking vitality (general decrease in performance, reduced activity, lacking interest in leisure activities, feeling of getting less done, of achieving less, of having to force oneself to undertake activities)
10. Decrease in muscular strength (feeling of weakness)
11.Depressive mood (feeling down, sad, on the verge of tears, lack of drive, mood swings, feeling nothing is of any use)
12.Feeling that you have passed your peak
13.Feeling burnt out, having hit rock-bottom
14.Decrease in beard growth
15.Decrease in ability/frequency to perform sexually
16.Decrease in the number of morning erections
17.Decrease in sexual desire/libido (lacking pleasure in sex, lacking desire for sexual intercourse)

Don't forget to take this to your doctor on your next visit.

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1. Heinemann LA, Saad F, Zimmermann T, et al. The Aging Males' Symptoms (AMS) scale: update and compilation of international versions. Health and quality of life outcomes. 2003;1:15.
2. Heinemann LAJ, Zimmermann T, Vermeulen A, Thiel. C. A new ‘Aging Male’s Symptoms’ (AMS) rating scale. The aging male : the official journal of the International Society for the Study of the Aging Male. 1999;2:105–114.
3. Daig I, Heinemann LA, Kim S, et al. The Aging Males' Symptoms (AMS) scale: review of its methodological characteristics. Health and quality of life outcomes. 2003;1:77.
4. Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 2010;95(6):2536-2559.
5. Lunenfeld B, Mskhalaya G, Zitzmann M, et al. Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. The aging male : the official journal of the International Society for the Study of the Aging Male. 2015;18(1):5-15.
6. Dean JD, McMahon CG, Guay AT, et al. The International Society for Sexual Medicine's Process of Care for the Assessment and Management of Testosterone Deficiency in Adult Men. The journal of sexual medicine. 2015;12(8):1660-1686.
7. Morales A, Bebb RA, Manjoo P, et al. Multidisciplinary Canadian Clinical Practice Guideline on the Diagnosis and Management of Testosterone Deficiency Syndrome in Adult Males. CMAJ. 2015.
8. Zitzmann M, Faber S, Nieschlag E. Association of specific symptoms and metabolic risks with serum testosterone in older men. J. Clin. Endocrinol. Metab. 2006;91(11):4335-4343.
9. Carruthers M. The paradox dividing testosterone deficiency symptoms and androgen assays: a closer look at the cellular and molecular mechanisms of androgen action. The journal of sexual medicine. 2008;5(4):998-1012.
10. Collier CP, Morales A, Clark A, Lam M, Wynne-Edwards K, Black A. The significance of biological variation in the diagnosis of testosterone deficiency, and consideration of the relevance of total, free and bioavailable testosterone determinations. J. Urol. 2010;183(6):2294-2299.
11. Morgentaler A, Khera M, Maggi M, Zitzmann M. Commentary: who is a candidate for testosterone therapy? A synthesis of international expert opinions. The journal of sexual medicine. 2014;11(7):1636-1645.
12. Heinemann LA, Moore C, Dinger JC, Stoehr D. Sensitivity as outcome measure of androgen replacement: the AMS scale. Health and quality of life outcomes. 2006;4:23.
13. Moore C, Huebler D, Zimmermann T, Heinemann LA, Saad F, Thai DM. The Aging Males' Symptoms scale (AMS) as outcome measure for treatment of androgen deficiency. Eur. Urol. 2004;46(1):80-87.
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Last updated: 2019