Aging Male Symptoms Questionnaire Research Articles

Validity and Reliability of the Turkish Male Andropause Symptoms Self-Assessment Questionnaire.

This study was planned to examine the validity and reliability of the Turkish version of the Male Andropause Symptoms Self-Assessment Questionnaire (MASS-Q). One hundred and twenty-five men with a mean age of 54.24 ± 6.51 years participated in the study. First, participants' demographic data were recorded. Then, the MASS-Q was adapted to Turkish. The assess the reliability and validity of the Turkish MASS-Q, internal consistency, test-retest reliability, and criterion validity analyses were administered. For the reliability test, the scale was readministered 1 week later. Test-retest reliability was examined with the intraclass correlation coefficients (ICCs). Internal consistency was defined by Cronbach's alpha. Regarding the validity analysis, content validity was determined according to expert opinions. For criterion validity, the Aging Male Symptoms-Questionnaire (AMS-Q) was used. According to the results of the analysis, the ICC values between the test-retest scores of the total and subdimensions (sexual, somatic, psychic, and behavior) of the MASS-Q were found to be 0.987, 0.939, 0.973, 0.951, and 0.887, respectively (P < 0.05). Cronbach's alpha values of the total and subdimensions (sexual, somatic, psychic, and behavior) of the MASS-Q were calculated as 0.924, 0.870, 0.747, 0.865, and 0.667, respectively. According to the ICC values obtained, it was found that the MASS-Q had a high degree of reliability. According to the internal consistency results, the sexual and psychic subdimensions were found to be quite reliable, whereas the somatic and behavioral subdimensions were found to be sufficiently reliable. According to the criterion validity results, a very high and high correlations were found between the AMS-Q scores and the MASS-Q scores (r = 0.636-0.938, P = 0.001). As a result, it was determined that the Turkish version of the MASS-Q is a valid and reliable scale that can be used in Turkish men.

Daily behavioral and sleep patterns are associated with aging-induced male-specific disorders in individuals with reduced renal function

The development of aging-induced male-specific disorders is accelerated by impaired renal function. Although aging-induced male-specific disorders are clinically serious complications in individuals with reduced renal function, their practical management strategies remain obscure. The purpose of this cross-sectional study was to investigate the association between daily behavioral and sleep patterns and aging-induced male-specific disorders in individuals with reduced renal function. Eighty men with glomerular filtration rate stage 2-4 (age, 67±9years), sedentary behavior and physical activity were assessed using a triaxial accelerometer. The mean sleep time was calculated from the sleep time during the accelerometer measurement. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Aging-induced male-specific disorders were assessed using the Aging Males' Symptoms Questionnaire (AMS). A lower moderate to vigorous-intensity physical activity (MVPA) time and a higher PSQI score were independently associated with a higher AMS score. Moreover, when the participants were divided into four groups according to the median MVPA values and the PSQI score (more or less than 6 points), the AMS score was the highest in those with a lower MVPA time and a higher PSQI score. In the mediation analysis, the PSQI score did not mediate a correlation between the MVPA time and AMS score. MVPA time also did not mediate a correlation between the PSQI and AMS scores. Collectively, these findings suggest that increasing MVPA time and improving sleep quality may contribute to attenuating aging-induced male-specific disorders in individuals with reduced renal function.

Weight Loss Through Bariatric Surgery in Men Presents Beneficial Effects on Sexual Function, Symptoms of Testosterone Deficiency, and Hormonal Profile

IntroductionMale obesity has a negative correlation with plasma testosterone (T) levels and sexual function (SF).AimTo evaluate the effect of weight loss through bariatric surgery (BS) on SF, low T symptoms, and hormonal profiles in obese men.MethodsThirty-three men who underwent BS participated in this cohort study. Before surgery, all participants underwent clinical examinations, including anthropometric, lipid, glycemic, and hormonal evaluations. SF was evaluated using the International Index of Erectile Function (IIEF) questionnaire; low T symptoms were evaluated using the Aging Males’ Symptoms (AMS) and Androgen Deficiency in the Aging Male (ADAM) questionnaires. The participants were reevaluated 6 months post-surgery.Main outcome measuresSex hormone profile, SF, and low T symptomsResultsAfter BS, a significant increase in mean total T (201 ± 111–548 ± 190 ng/dL, P < .001), free T (5.8 ± 2.8–9.3 ± 3.4 ng/dL, P < .001), bioavailable T (110.3 ± 57.8–198.6 ± 74.3 ng/dL, P < .001), and sexual hormone-binding globulin (19.8 ± 13.7–54.6 ± 23.2 nmol/L, P < .001) levels. There was a significant decrease in estradiol (64.6 ± 27.4–29.2 ± 20.0 [pg/mL], P < .001). SF significantly improved. The total IIEF score increased 5.2 points (62.3 ± 7.4–67.5 ± 7.4, P = .004), erectile function subdomain increased 2.4 points (25.7 ± 4.1–28.1 ± 3.9, P = .011), desire subdomain increased 1.0 points (8.3 ± 1.5–9.3 ± 1.6, P = .006), and intercourse satisfaction subdomain increased 1.2 points (11.4 ± 1.9–12.6 ± 1.8, P = .012). Post-surgery, a 44% reduction (P = .001) was observed in the positive ADAM questionnaire, and improvements in all domains of the AMS questionnaire were found (P < .001).ConclusionSignificant weight loss through BS improves erectile function, hormonal profile, and symptoms of T deficiency.Machado FP, Rhoden EL, Pioner SR, et al. Weight Loss Through Bariatric Surgery in Men Presents Beneficial Effects on Sexual Function, Symptoms of Testosterone Deficiency, and Hormonal Profile. Sex Med 2021;9:100400.

Regular aerobic exercise improves sexual function assessed by the Aging Males’ Symptoms questionnaire in adult men

The leading cause of aging-induced male-specific disorders such as physical, mental and/or sexual symptoms is testosterone deficiency. Although aerobic exercise is suggested to improves circulating testosterone levels, physical fitness, depressive symptoms, and sexual function, the effect of regular aerobic exercise on aging-induced disorders has not yet been clarified. Here we performed cross-sectional and interventional studies to identify the effect of aerobic exercise on aging-induced disorders assessed by the Aging Males’ Symptoms questionnaire (AMS). In study 1, the relationship between aerobic exercise capacity (i.e. peak oxygen consumption) and AMS scores were cross-sectionally examined in 169 adult men. In study 2, the effect of a 12-week regular aerobic exercise on AMS scores was longitudinally investigated in 18 adult men. In study 1, the AMS-total, AMS-somatic, AMS-psychological, and AMS-sexual scores were significantly correlated to aerobic exercise capacity even after considering age and testosterone levels. In study 2, 12-week aerobic exercise training significantly improved AMS-sexual and tended to improve AMS-total scores. Additionally, an increase in vigorous physical activity was correlated to improve in the AMS-sexual score. These results suggest that regular aerobic exercise is an effective strategy to improve aging-induced disorders in men.

Optimizing Aging Male Symptom Questionnaire Through Genetic Algorithms Based Machine Learning Techniques.

PurposeGenetic algorithm (GA) is a machine learning optimization strategy where sample strategies compete for fitness to evolve an optimum solution. This study evolves the Aging Male Symptoms (AMS) with GA to better identify late onset hypogonadism (LOH) with serum testosterone.Materials and MethodsGA was trained on a training set of standard AMS questionnaire on a nationwide LOH epidemiology study. Random matrices of selectors for particular items were generated. Each generation of was evolved through a fitness function determined by sensitivity. Threshold to determine positive serum testosterone level for LOH was randomized for each competing strategy. After 2,000 runs, with each run producing the best result out of a set of 3,000 randomly generated sets evolved through 300 generations, the best AMS selection matrix was then applied to a separately enrolled validation set to compare outcomes.ResultsPredictability for serum testosterone levels dropped markedly above 3.5 ng/mL during pilot training. Limiting the training to testosterone thresholds between 2.5 and 3.5 ng/mL the GA 93 different strategies. Only a selection of 5 items, determining for a threshold of 20 points and determining for a serum testosterone level of 3.16 ng/mL, showed robust reproducibility within the internal validation set. Applying these conditions to the independent validation set showed sensitivity improved from 0.66 to 0.77, with a specificity of 0.07 to 0.19, respectively.ConclusionsGA method of selecting questionnaires improved AMS questionnaire significantly. This method can be easily applied to other questionnaires that do not correlate with physiological markers.

The severity of hypogonadism symptoms and its risk factors among male employees of Tehran University of Medical Sciences

Objectives The current study was conducted to examine the severity of hypogonadism symptoms and their risk factors among the male employees of Tehran University of Medical Sciences (TUMS). Methods This cross-sectional study was conducted on 80 male employees aged 40–60 years, with hypogonadism, at TUMS. The participants were selected through census sampling. The data collection tools included the demographic questionnaire and the Aging Male Symptoms (AMS) questionnaire. The participants first completed the demographic questionnaire and then the AMS questionnaire. SPSS statistical software version 22 (Chicago, IL) was used to analyze the data, and one-way ANOVA tests, Pearson’s correlation coefficient, and stepwise multivariate logistic regression were applied. Results Based on our findings, the mean overall score of hypogonadism symptoms was 41.71 ± 9.20. Based on Pearson’s correlation coefficient results, there was a statistically significant association between the severity of hypogonadism symptoms and age (p < .001). Furthermore, there were significant associations between the economic status, cigarette consumption and hours of sleep and the severity of hypogonadism symptoms (p < .001). Conclusions The current study’s results showed that certain factors can affect hypogonadism in males. Thus, it is important to reduce the severity of hypogonadism symptoms and to modify the factors related to this phenomenon.

The presence of symptoms of testosterone deficiency in the exercise-hypogonadal male condition and the role of nutrition.

High volumes of aerobic exercise have been associated with reduced testosterone (T), known as the exercise-hypogonadal male condition (EHMC). Although the presence of low T has been identified, few studies have assessed the presence of androgen-deficient symptoms. The purpose of this investigation is to assess men exhibiting EHMC and evaluate their hypothalamic-pituitary-gonadal axis, the presence of hypogonadal symptoms, and also investigate a possible contribution of inadequate nutrition to the condition. A cross-sectional design compared 9 long-distance runners exhibiting EHMC to 8 non-active controls. Comparisons included serum T, luteinizing hormone (LH), follicle-stimulating hormone, and cortisol, the Aging Male Symptoms (AMS) questionnaire score, bone mineral density (BMD), and a food frequency questionnaire. Mean T was significantly reduced in the EHMC group (EHMC 9.2nmolL-1 vs. CONT 16.2nmolL-1). The EHMC group demonstrated significantly higher AMS scores (EHMC 27.1±7.3 vs. CONT 19.7±2.5). There were no differences in bone density, although 3 cases of osteopenia were noted for EHMC in the lumbar spine, 1 in the right femur, and 1 in the radius. Energy availability was significantly reduced in EHMC (EHMC 27.2±12.7 vs. CONT 45.4±18.2kcaldFFM-1). Men exhibiting EHMC do appear to present with symptoms associated with androgen deficiency. For the most part, these symptoms are limited to those reported on the AMS questionnaire, although there are also some cases of clinically low BMD. It is possible that inadequate energy intake is contributing to this condition.

Comparing calculated free testosterone with total testosterone for screening and diagnosing late-onset hypogonadism in aged males: A cross-sectional study.

The aim of this study is to compare calculated free testosterone (cFT) and total testosterone (T) in predicting late-onset hypogonadism (LOH) in middle-aged and elderly males. We surveyed a random sample of 608 males between the ages of 45 and 87years from Shanghai, China. The Aging Male Symptoms (AMS) questionnaire and the Androgen Deficiency in Aging Male (ADAM) questionnaire were completed by the subjects. Testosterone (T), sex hormone-binding globulin (SHBG), albumin, and other blood biochemical indexes were measured in 332 males. The corresponding cFT was obtained using the Vermeulen formula and the correlations between T and cFT were analyzed by SPSS statistical software. Among the 332 males who underwent biochemical evaluation, 289 males (87.0%) was positively screened by the ADAM questionnaire and 232 males (69.9%) by the AMS questionnaire. As suggested by linear regression, cFT exhibited a negative correlation with age in both ADAM+ and AMS+ group, whereas T did not appear to have significant correlation with age. Besides, there were statistically significant differences in cFT (P<.001) in the AMS questionnaire. Calculated free testosterone levels are more reliable than T levels for diagnosing LOH in middle-aged and elderly males.

Influence of the testosterone therapy (1 % transdermal gel) on the life quality of men of androgen deficiency in terms of routing clinical practice: 6 months monitoring test

Маterials and methods. The study hereunder was an open multicenter surveillance non-intervention study at men with testosterone deficiency, apllying daily 1 % testosterone gel (Аndrogel®) in the dosage of 50 or 100 mg (with possible titration) in terms of routine clinical practice. The initial end point was the life quality, referred to the health status, evaluated at the filling of the questionnaire on Aging Males’ Symptoms (AMS). As secondary end points served changes of the total score of the International Erectile Function Index (IEFE) and its domains, changes of body weight index (BWI) and of the waist circumference, correlation of changes in life quality indices, determined with AMS questionnaire, with laboratory indices of the testosterone level and of the data by the IEFE scale, demographic features, as well as original characteristics of patients, anamnesis of diagnostic and therapeutic procedures, reason for the treatment termination and any adverse effects, arising in the course of treatment with Androgel®. Results. The data on 196 of 202 patients, included in studies, was available for processing after 6 months of monitoring. Average values of the total testosterone level in beginning of studies were 10.8 ± 0.3 (95 % confidence interval (CI) 10.2–11.4) nmol/l after 6 months of therapy – 21.1 ± 0.4 (95 % CI 20.4–21.9) nmol/l. Significant changes were marked on the AMS scale, the average point at the 1st visit was 47.4 ± 1.0 (95 % CI 45.5–49.4), аnd at the 4th – 27.5 ± 0.8 (95 % CI 25.9–29.1); by IEFE scale at the 1st visit – 33.0 ± 1.0 (95 % CI 31.0–35.0), at the 4th – 54.0 ± 1.0 (95 % CI 52.0–57.0). Additional positive effects were marked as to BWI and the waist circumference – decrease of indices by 1,2 kg/m2 and 5 сm accordingly. Conclusion. Studies have shown the authentic reduction of expressed symptoms of testosterone deficiency, improvement of the life quality indices and of the sexual function. During 6 months of monitoring no clinically significant adverse effects were revealed.

Re: The treatment of late-onset hypogonadism

Hypogonadism has clearly been shown to influence sexual and multi-system function.[1–3] In this article,[4] the authors reviewed the negative effects of late-onset hypogonadism (LOH) on different systems and gave details on treatment of it. LOH that is defined by reduced serum testosterone levels associated with clinical symptoms at middle ages mainly seen after 40 years old. Testosterone, formerly known associated with sexual function, goes far beyond sexual function and is now considered a hormone with numerous effects on male physiology, in particular regarding metabolic functions. It is well documented that testicular testosterone production decreases in men with ageing, by 1–2% per year.[5] However, on average serum levels of testosterone still remain within the normal range of young men. “Who should be offered testosterone replacement?”. There is still no general consensus on the threshold of circulating testosterone below which replacement therapy is recommended. The panelists for the Endocrine Society guideline failed to reach a consensus regarding the testosterone threshold for older men, as some of them favored a threshold of 9.7–10.4 nmol/L; whereas, others felt that a threshold of 6.9 nmol/L was more appropriate.[6] In case of dilemma, questionnaires like Aging Males’ Symptoms Questionnaire (AMS-Q), which has validated Turkish version, can be helpful. Evidences support the concept that testosterone is an anabolic hormone with a wide range of beneficial effects on men’s health. The therapeutic role of testosterone in men’s health, however, remains a hotly debated issue for a number of reasons, including the purported risk of prostate cancer. As urologists, we always asked a critical question “Is there any existing relation between testosterone and the development of prostate pathology (prostate cancer and/or hyperplasia)?”. The answer was given in a very recent review of current literature[7] regarding the relationship of serum testosterone on prostate cancer. The results dispelled the historical fear that raising testosterone levels will result in more prostate cancer. Studies have failed to show increased risk of prostate cancer in men with higher serum testosterone, and supraphysiological testosterone fails to increase prostate volume or prostate specific antigen in healthy men. This apparent paradox is explained by the “saturation model,” which posits a finite capacity of androgen to stimulate growth of prostate cancer. Modern studies indicate no increased risk of prostate cancer among men with serum testosterone in the therapeutic range.[7] In conclusion, testosterone is not a “niche” hormone, but a multi system hormone with much wider range of actions than reproduction or sexual functions. Early recognition and treatment of patients with LOH might help reduce the likelihood that these aforementioned[4] clinical features progress.

Inverse relationship between scores on the quality of life questionnaire SF-12 and on the Aging Males' Symptoms scale in Italian men

Objectives. To analyse the relation between results of the Aging Males' Symptoms (AMS) questionnaire for aging males, and of quality of life (QOL) questionnaire SF-12 and cardiovascular risk factors.Methods. 1,927 men aged 55–85 years were interviewed by 56 general practitioners. During the interview the men were asked to fill in the AMS scale and the QOL questionnaire SF-12.Results. Of 1,927 men 1,806 men filled correctly the AMS questionnaire. The mean SF-12 mental index was respectively 55.9 in men with a total AMS score indicating no impairment, 50.9 mild, 42.8 moderate, and 32.8 severe impairment. The corresponding values for the physical index were 51.2, 46.7, 40.8 and 32.3.A history of diabetes was associated with an increased risk of reporting moderate/severe impairment: in relation to the total AMS score the odds ratio, (OR), of moderate/severe impairment in comparison with no impairment was 1.6 (95%CI 1.2–2.1). A history of myocardial infarction and hypertension increased the risk (respectively OR 1.4 (95%CI 1.1–18) and 1.7 (95%CI 1.2–2.4)).Conclusions. This study shows that higher AMS scores are associated with lower SF-12 indices and suggests that elevated values of the AMS score are associated with cardiovascular risk factors or diseases.

Is Sildenafil Citrate Associated With an Amelioration of the Symptomatology of Androgen Decline in the Aging Male?

We examined whether treatment of erectile dysfunction with sildenafil citrate is associated with amelioration of the symptomatology of androgen decline in the aging male, and whether this alters the endocrine pattern. A double-blind, randomized, placebo controlled, crossover study with sildenafil citrate was conducted in 60 men (age range 47 to 75 years old) who presented with erectile dysfunction and screened positively for androgen decline in the aging male by the questionnaire of the same name. The patients were randomized to receive sildenafil citrate or placebo in a 1:1 ratio and were crossed over after 3 months of treatment for an additional 3 months. The evaluation included International Index Erectile Function and Aging Male Symptoms questionnaires, hormonal profiles, total testosterone, and bioavailable testosterone. A total of 40 patients completed the study. Compared to placebo, sildenafil citrate improved erectile function (52.7 +/- 2 vs 39 +/- 1.9, p <0.001) and Aging Male Symptoms score (33.5 +/- 1.3 vs 28.6 +/- 1.3, p <0.001) in the total group. Breakdown into hypogonadal and normal men showed that the International Index of Erectile Function score improved more in normal (Delta 18.5 +/- 3.6) than in hypogonadal men (Delta 6.7 +/- 2.7). There were no differences in improvement on the Aging Male Symptoms questionnaire between hypogonadal and normal men. No treatment changes were observed in total testosterone and bioavailable testosterone. In the total group of patients sildenafil citrate was associated with expected improvement in erectile function and in the Aging Male Symptoms questionnaire without any alteration in hormonal pattern. The available questionnaires for androgen decline in the aging male are not specific for the diagnosis of biochemical androgen decline in the aging male, although the suboptimal response to sildenafil citrate suggests the presence of hypogonadism.

Correlation Between the Aging Males’ Symptoms Scale and Sex Steroids, Gonadotropins, Dehydroepiandrosterone Sulfate, and Growth Hormone Levels in Ambulatory Men

Partial androgen deficiency of the aging male (PADAM) is defined as a biochemical syndrome associated with advancing age that is characterized by a deficiency in serum androgen levels. The Aging Males' Symptoms (AMS) Scale was developed to evaluate PADAM-related symptoms and is currently used worldwide; however, it has been reported that PADAM-related symptoms evaluated by this scale are not related to serum testosterone levels. In addition to testosterone, the levels of other hormones also decrease with age; therefore, multihormone alterations may influence PADAM-related symptoms. To investigate the relationship between PADAM-related symptoms evaluated by the AMS Scale and serum levels of testosterone, estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEA-S), and growth hormone (GH) in men. A total of 141 ambulatory men were recruited after excluding men with endocrine and other related diseases. All participants completed the AMS questionnaire and an analysis of serum levels of total and free testosterone (TT and FT), E2, LH, FSH, DHEA-S, and GH. The relationship between AMS scores (total and subscores) and serum hormone levels was determined. There were significant negative correlations between age and serum FT and DHEA-S levels, as well as positive correlations between age and serum LH and FSH levels, but no correlation between age and AMS scores. None of the three AMS domain scale scores and total scores significantly correlated with serum levels of TT, FT, E2, LH, FSH, DHEA-S, or GH. The results of the present study suggest that PADAM-related symptoms as evaluated by the AMS Scale are not significantly related to serum levels of TT, FT, E2, LH, FSH, DHEA-S, or GH. Because many factors related to aging are thought to contribute to the occurrence of PADAM-related symptoms, the AMS Scale may not be able to predict serum hormone levels.