| Yes | No | |
| Have you experienced a decrease in libido (sex drive)? | ||
| Do you lack energy? | ||
| Has your strength or endurance decreased? | ||
| Have you lost height? | ||
| Have you noticed a decreased ‘enjoyment of life’? | ||
| Are you sad or grumpy? | ||
| Are your erections less strong? | ||
| Has your ability to play sports deteriorated recently? | ||
| Do you fall asleep after dinner? | ||
| Has there been a downturn in your work performance? |