3 minute read

What is the AMS scale and how does it help diagnose low testosterone?

By Nick Harland | Medically reviewed by Dr Nimlan Shanmugathas
what is the ams scale

It’s a bit of a paradox: low testosterone is easy to identify, yet millions of men in the UK are going undiagnosed every year. One of the reasons why is that many men simply don’t know the symptoms of testosterone deficiency (TD).

The AMS scale is helping to bridge that knowledge gap. It’s a simple way of finding out whether you have symptoms consistent with TD, allowing you to follow up on your results and take better control of your health.

Here’s all you need to know about the questionnaire and how it can help to diagnose TD.

What is the AMS scale?

The Aging Males' Symptoms (AMS) scale is a set of 17 questions that help to identify a testosterone deficiency. You’re presented with a range of symptoms (e.g. sleep problems) and asked to rate their seriousness from 0 (none) to 5 (severe). You’ll get a total score out of 85.

  • A score of 26 or under means you have no significant symptoms consistent with a low testosterone level.

  • 27-36: you have mild symptoms consistent with a low testosterone level.

  • 37-49: you have moderate symptoms consistent with a low testosterone level.

  • Over 50: you have severe symptoms consistent with a low testosterone level.

Of course, a high score alone doesn’t necessarily mean you have TD. But if your test does throw up some unexpected results, your next step should be a blood test to confirm the results of the questionnaire.

Who is it aimed at?

Despite the name, the AMS scale is relevant for men of all ages.

Your testosterone levels start to decrease by around 1% a year once you hit your 30s. However, that doesn’t mean TD is limited to over 30s. It can affect younger men too, so the questionnaire is still worth taking if you have a few unexplained symptoms that you can’t get to the bottom of.

Which questions does it ask?

The AMS scale lists 17 symptoms related to low testosterone levels. You just have to rate the impact of each one. Here is the full list of symptoms in the questionnaire:

  • Decline in your feeling of general wellbeing

  • Joint pain and muscular ache

  • Excessive sweating

  • Sleep problems

  • Increased need for sleep, often feeling tired

  • Irritability

  • Nervousness

  • Anxiety

  • Physical exhaustion / lacking vitality

  • Decrease in muscular strength

  • Depressive mood

  • Feeling that you have passed your peak

  • Feeling burnt out, having hit rock-bottom

  • Decrease in beard growth

  • Decrease in ability/frequency to perform sexually

  • Decrease in the number of morning erections

  • Decrease in sexual desire/libido

What are the benefits of the questionnaire?

The main aim of the test is to help diagnose a testosterone deficiency. However, there are plenty of other benefits:

  • You can start to join the dots between different symptoms to see if there’s a pattern and underlying cause

  • It quantifies your health issues, allowing you to put a number on things and making it easier to track concerns over time

  • It helps to detect health concerns early on, meaning you can act on unusual results before they become a bigger problem

  • Having a set of results to refer to makes it easier for some men to discuss sensitive issues with their doctor

Can the AMS scale diagnose TD?

No. Although your AMS results can indicate a testosterone deficiency, only a blood test can tell you for sure whether or not you have one.

To confirm a diagnosis of testosterone deficiency, you need to take two tests spaced at least two weeks apart. This is because your testosterone levels fluctuate naturally, so two tests can confirm whether you have consistently low testosterone and can also help to identify a baseline from which to work from.

That being said, the questionnaire is generally seen as a good indicator of TD. One study found that it was a reliable way of identifying early symptoms and then monitoring the effectiveness of follow-up treatments.

What should I do if my results indicate a potential testosterone deficiency?

If you get a score of 27 or more on the AMS scale, it’s recommended that you measure your testosterone levels with a Venous Blood Test (VBT), known as the gold-standard for accuracy and reliability. If the blood test confirms the results of the questionnaire, your next step is to discuss treatment options with a clinician. They may recommend testosterone replacement therapy (TRT), lifestyle changes, symptom management, or weight loss to restore your levels to normal.

The numan take

The Ageing Males’ Symptoms (AMS) scale is a set of 17 questions that help to identify if you may have testosterone deficiency. Beyond that it can also help you track your health over time, and empower you to make better decisions for your long-term wellbeing. The questionnaire alone can’t diagnose a testosterone deficiency, but it’s a vital first step to identifying and correcting one.