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Sexual Dysfunction
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Learn More About:
Male Infertility
Male Sexual Dysfunction
Andropause
Female Sexual Dysfunction
No-Scalpel, No-Needle Vasectomy
Adolescent Varicoceles
Vasectomy reversal
Semen Analysis
Sperm Banking
Other Sites by
Michael A. Werner, M.D., FACS:
The Medical Center for Female Sexuality
M.A.Z.E. Cord Blood Laboratories
M.A.Z.E. Andrology Laboratories
Sexual Dysfunction
Sexual Health
Sexual Dysfunction
Female Sexual Dysfunction
Male Sexual Dysfunction
Testosterone
Sex Drive
Impotence/Erectile Dysfunction
Premature Ejaculation
Peyronies Disease
Andropause
ADAM QUESTIONNAIRE
Please check
YES
or
NO
YES
NO
1
Do you have a decrease in libido (sex drive)?
2
Do you lack energy?
3
Is your strength or endurance decreased?
4
Have you lost height?
5
Have you noticed decreased “enjoyment of life”?
6
Are you sad or grumpy?
7
Are your erections less strong?
8
Have you noticed a recent deterioration in your ability to play sports?
9
Do you fall asleep after dinner?
10
Has there been a deterioration in your work performance?
Modified on Feb. 1, 2010
2975 Westchester Ave. Purchase, N.Y. 10577 Also serving the New Jersey (NJ) area. Tel: 914-997-4100 Fax: 914-683-0974
148 East Ave. Norwalk, CT 06851 Tel: 203-831-9900
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Copyright © 2007-2010 Michael A. Werner, M.D., FACS. All rights reserved
