Do you have a decrease in libido (sex drive)?

Yes No

Do you have a lack of energy?

Yes No

Do you have a decrease in strength and endurance?

Yes No

Have you lost height?

Yes No

Have you noticed a decreased “enjoyment of life”?

Yes No

Are you sad and/or grumpy?

Yes No

Are your erections less strong?

Yes No

Have you noticed a recent deterioration in your ability to play sports?

Yes No

Are you falling asleep after dinner?

Yes No

Has there been a recent deterioration in your work performance?

Yes No