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Which of the following symptoms apply to you currently (in the last 2 weeks)?
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Sweating (night sweats or excessive sweating)
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Sleep problems (difficulty falling asleep, sleeping through the night or waking up too early)
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Increased need for sleep or falls asleep easily after a meal
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Depressive mood (feeling down, sad, lack of drive)
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Irritability (mood swings, feeling aggressive, angers easily)
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Anxiety (inner restlessness, feeling panicked, feeling nervous, inner tension)
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Physical exhaustion (general decrease in muscle strength or endurance, decrease in work performance, fatigue, lack of energy, st
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Sexual problems (change in sexual desire or in sexual performance)
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Bladder problems (difficulty in urinating, increased need to urinate)
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Erectile changes (weaker erections. loss of morning erections)
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Joint and muscular symptoms (joint pain or swelling, muscle weakness. poor recovery after exercise)
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Difficulties with memory
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Problems with thinking, concentrating or reasoning
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Difficulty learning new things
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Trouble thinking of the right word to describe persons. places or things when speaking
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Increase in frequency or intensity of headaches/migraines
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Rapid hair loss or thinning
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Feel cold all the time or have cold hands or feet
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Weight gain, increased belly fat. or difficulty losing weight despite diet and exercise
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Infrequent or absent ejaculations
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Total score
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Severity score: Mild: 1-20 / Moderate: 21-40/ Severe: 41-60 / Very severe: 61-80
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