Do I Have Low Testosterone?

What this screener tells you

The core symptom instrument behind this screener is ADAM — Androgen Deficiency in Aging Males. ADAM is a 10-item yes-or-no questionnaire developed at Saint Louis University and validated against serum testosterone testing. It is the most widely used symptom screen for low testosterone in primary care. Reported performance is approximately 88 percent sensitivity and 60 percent specificity, which means it catches most men who actually have low testosterone but produces a meaningful number of positive screens that do not hold up on lab work.

Disclosure: approximately 40 percent of positive ADAM screens are not associated with biochemical hypogonadism — only a serum testosterone test can confirm. That is a feature of the tool, not a flaw. ADAM is designed to be sensitive at the front door so men who could have low testosterone do not get filtered out before lab work happens.

The screener also incorporates two short-form safety instruments. A PSA prompt captures a recent prostate-specific antigen value if you have one, and the IPSS short-form is a validated 3-item urinary symptom score. Both are designed to surface confounders that warrant a urology workup before any testosterone-based therapy is even considered. What this screener does not do: it does not diagnose low testosterone, it does not prescribe anything, and it does not replace a clinician.

Why an in-person clinic in Park Ridge

Many online low-testosterone services run on a 4-marker hormone screen and a video visit, and skip the in-person exam, the same-day lab draw, and the comprehensive panel — the parts that drive a good clinical decision for some patients.

Moonshot Medical is a real bricks-and-mortar clinic in Park Ridge, Illinois. We see you in person. We run a 60-plus marker comprehensive panel — not a 4-marker screen — so we can rule out the things that mimic low testosterone (thyroid disease, anemia, vitamin and mineral deficiencies, sleep apnea risk markers, pituitary signaling problems, metabolic dysfunction) before attributing everything to testosterone. And because you are in the room, we can do real exam steps that matter for men's health screening — including the parts most telehealth visits skip — rather than punting them to "your primary."

If the screener flags meaningful eligibility factors, the next step is a structured intake visit with full labs. Local. Real. Same building. Real continuity of care, not a prescription mailed from out of state.

What the screener checks

In plain English, the screener walks through:

• 10-item ADAM symptom check. The validated low-testosterone symptom questionnaire — energy, libido, strength, mood, work performance, height loss, after-dinner sleepiness, and erectile changes.
• Body context. Age, height, and weight — used as context for clinical interpretation, not as a verdict.
• Sleep quality and OSA red flags. Sleep duration, snoring, witnessed apneas, and morning headaches — because untreated obstructive sleep apnea suppresses testosterone and is one of the most common reversible causes.
• Fertility plans. Whether you are trying to conceive now, planning to in the next 12 months, or have completed your family — because traditional testosterone-based therapy can suppress fertility.
• Medical history safety screen. Cancer history (especially prostate and breast), cardiovascular disease, prostate disease, urinary symptoms, sleep apnea, and mood disorders. These categories shape which evaluation paths are appropriate.
• PSA short-form. A recent prostate-specific antigen value if you have had one drawn — the screener asks for it as context, never as a diagnosis.
• IPSS short-form. A validated 3-item urinary symptom score covering frequency, urgency, and weak stream.
• Current medications. Some prescription medications — opioids, certain antidepressants, glucocorticoids, and others — directly suppress testosterone and need to be on the table before any conclusions are drawn.

None of these inputs alone produces a verdict. The screener combines them to estimate whether a clinical evaluation for hypogonadism is warranted, and whether any confounders should be addressed first.

Common questions

What is ADAM and how accurate is it?

ADAM stands for Androgen Deficiency in Aging Males. It is a 10-item yes-or-no symptom questionnaire developed at Saint Louis University and validated against serum testosterone testing. ADAM has approximately 88 percent sensitivity and 60 percent specificity. In plain English, it catches most men who actually have low testosterone, but roughly 40 percent of positive screens are not associated with biochemical hypogonadism. ADAM is a triage tool, not a diagnostic test. Only a serum testosterone blood draw can confirm low testosterone.

Why does the screener ask about PSA and urinary symptoms?

Because both can change how a clinician approaches the conversation. An elevated PSA can signal a prostate condition that warrants urology evaluation before any testosterone-based therapy is considered. The IPSS short-form is a validated 3-item urinary symptom score that flags lower urinary tract symptoms which sometimes worsen with testosterone-based therapy. Asking up front lets a clinician steer the conversation toward the safest evaluation path for you, and avoids wasted visits when a urology workup is the appropriate first step.

If I'm trying to conceive, can I still consider testosterone therapy?

Traditional testosterone-based therapy can suppress fertility. Several non-testosterone-based approaches exist that may preserve fertility — these require clinical evaluation to determine fit. The screener asks about fertility plans because the right path forward depends on whether you and a partner are actively trying to conceive, planning to conceive in the next 12 months, or have already completed your family. A clinician will walk through the trade-offs once a serum testosterone level confirms what is actually going on.

What's the difference between this screener and a serum testosterone test?

This screener is a validated symptom questionnaire layered with a safety check. It tells you whether your reported symptoms, history, and confounders justify a clinical evaluation. A serum testosterone test is a blood draw, ideally fasting and before 10 a.m., that measures your actual testosterone level — usually total testosterone, free testosterone, SHBG, LH, FSH, estrogen (E2), and prolactin. At Moonshot Medical the lab work is part of a 60-plus marker comprehensive panel, not a 4-marker screen, so confounders like thyroid disease, anemia, and metabolic dysfunction are caught at the same time.

If my screener says "eligibility factors present," does that mean I have low testosterone?

No. A positive screen means your reported symptoms and history are consistent with the pattern seen in men who later test low on serum testosterone — but it is not a diagnosis. About 4 in 10 men with a positive ADAM screen turn out to have a normal serum testosterone level when blood is drawn correctly. The screener is a triage tool to decide whether a clinical visit and lab work are worth your time. Only the lab draw, paired with a focused exam and history, can confirm hypogonadism.

What about tadalafil (Cialis)?

Tadalafil (sometimes branded Cialis) is FDA-approved for erectile dysfunction, benign prostatic hyperplasia (BPH), and combined ED + BPH symptoms. Daily low-dose tadalafil is a separate evaluation track from testosterone-based therapy — it doesn't suppress fertility, and it can be appropriate for men whose primary concerns are erectile or lower-urinary-tract symptoms. Whether it's a fit for you is a clinical decision based on your full picture. Our Daily Tadalafil page covers what to expect.

Related screeners and reading

• Bone density screener — low testosterone is itself a recognized driver of accelerated bone loss in men.
• Men's hormone care — service overview, what's included, and how to book.
• Low testosterone symptoms — what symptoms actually predict low T, and which ones are usually something else.
• TRT guide — formulations, monitoring, and what a real evaluation pathway looks like.
• Testosterone levels by age — typical reference ranges and how interpretation changes through the decades.