Andropause Questionnaire

 

 

 

I have difficulty getting asleep                                       No       Yes     How often?             

 

I have difficulty staying asleep                                      No       Yes     How often?              

 

I feel more tired than usual                                               No       Yes     How often?              

 

I feel irritable                                                                         No      Yes     How often?              

 

I feel anxious or nervous                                                    No       Yes     How often?              

 

I feel depressed                                                                  No       Yes     How often?              

 

I have less strength or endurance                                   No       Yes     How often?              

 

My energy is diminished                                                    No       Yes     How often?              

 

I lack desire or interest in sexual activity                         No       Yes     How often?              

 

I have erectile dysfunction                                                 No       Yes     How often?