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Aging Males' Symptoms (AMS) scale

Background Information

The Aging Males’ Symptom (AMS) scale allows for a more quantitative assessment of testosterone deficiency (TD) compared to the ADAM score. It consists of 17 questions that have been well validated and aid in the diagnosis of testosterone deficiency. The AMS can confirm the presence of symptoms that are associated with low testosterone such as diminished erections, low desire, flushing and sweating. The AMS can also help differentiate the primary cause of erectile dysfunction e.g. low testosterone versus vascular issues. Patients with normal testosterone levels that have a vascular component still maintain desire, although they have a diminished ability to perform sexually. The output of this calculator will provide a summary of all responses and an overall assessment which can be very useful in writing a medical progress/clinic note.

Scoring:
The program will generate four different scores:

  1. Total score based on all 17 items. Each item is scored from 1 to 5 depending on the response with 5 being the most severe. [Minimum score: 17.  Maximum score: 85]
  2. There are three sub-scales (sub-dimensions) built into the form.  The calculator will provide a score for each dimension.
  3. Somatic subscale: consists of questions 1 through 5, plus questions 9 and 10.
  4. Psychological subscale: consists of questions 6 through 8, and questions 11 and 13.
  5. Sexual subscale: consists of question 12, and 14 through 17.

 Evaluation:   A diagnosis of  low testosterone is made after confirming the existence of symptoms consistent with TD and a sub-optimal testosterone level.

AMS scoring (total score):
< 26 means you have no significant symptoms consistent with a low testosterone level.
27-36 means you have mild symptoms consistent with a low testosterone level.
37-49 means you have moderate symptoms consistent with a low testosterone level.
> 50 means you have severe symptoms consistent with a low testosterone level.

Patients with a score of 27 or higher should have their serum serum testosterone level drawn.

Instructions

The following questions refer to symptoms of low testosterone. Every question must be answered and the response should be based on what symptoms apply to you at this time.  For symptoms that do not apply, please select “none”.
1. Decline in your feeling of general well-being
(general state of health, subjective feeling)

None
Mild
Moderate
Severe
Extremely severe
2. Joint pain and muscular ache
(lower back pain, joint pain, pain in a limb, general back ache)

None
Mild
Moderate
Severe
Extremely severe
3. Excessive sweating
(unexpected/sudden episodes of sweating, hot flushes independent of strain)

None
Mild
Moderate
Severe
Extremely severe
4. Sleep problems
(difficulty in falling asleep, difficulty in sleeping through, waking up early and
feeling tired, poor sleep, sleeplessness)

None
Mild
Moderate
Severe
Extremely severe
5. Increased need for sleep, often feeling tired

None
Mild
Moderate
Severe
Extremely severe
6.  Irritability
(feeling aggressive, easily upset about little things, moody)

None
Mild
Moderate
Severe
Extremely severe
7. Nervousness
(inner tension, restlessness, feeling fidgety)

None
Mild
Moderate
Severe
Extremely severe
8. Anxiety
(feeling panicky)

None
Mild
Moderate
Severe
Extremely severe
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)

None
Mild
Moderate
Severe
Extremely severe
10. Decrease in muscular strength
(feeling of weakness)

None
Mild
Moderate
Severe
Extremely severe
11. Depressive mood
(feeling down, sad, on the verge of tears, lack of drive, mood swings, feeling
nothing is of any use)

None
Mild
Moderate
Severe
Extremely severe
12. Feeling that you have passed your peak

None
Mild
Moderate
Severe
Extremely severe
13. Feeling burnt out, having hit rock-bottom

None
Mild
Moderate
Severe
Extremely severe
14. Decrease in beard growth

None
Mild
Moderate
Severe
Extremely severe
15. Decrease in ability/frequency to perform sexually

None
Mild
Moderate
Severe
Extremely severe
16. Decrease in the number of morning erections

None
Mild
Moderate
Severe
Extremely severe
17. Decrease in sexual desire/libido
(lacking pleasure in sex, lacking desire for sexual intercourse)

None
Mild
Moderate
Severe
Extremely severe
Have you got any other major symptoms? 

If Yes, please describe:

Background Info

References

Heinemann L., Saad F., Zimmermann T. The Aging Males' Symptoms (AMS) scale: update and compilation of international versions. Health Qual Life Outcomes. 2003;1:15. [PubMed]

Aging Males Symptoms (AMS) scale Low Testosterone