Which of the following symptoms apply to you at this time? Please, mark the appropriate box for each symptom. For symptoms that do not apply, please mark “none”.

1. Decline in your feeling of general well being (general state of health, subjective feeling)
2. Joint pain and muscular ache (lower back pain, joint pain, pain in a limb, general back ache)
3. Excessive sweating (unexpected/ sudden episodes of sweating, hot flushes independent of strain)
4. Sleep problems (difficulty in falling asleep, difficulty in sleeping through, waking up early and feeling tired, poor sleep, sleeplessness)
5. Increased need for sleep, often feeling tired
6. Irritability (feeling aggressive, easily upset about little things, moody)
7. Nervousness (inner tension, restlessness)
8. Anxiety (feeling panicky)
9. Physical exhaustion/lacking vitality (general decrease in performance, reduced activity, feeling of getting less done, of having to force oneself to undertake activities)
10. Decrease in muscular strength (feeling weak)
11. Depressive mood (feeling down, sad, on the verge of tears, mood swings)
12. Feeling that you have passed your peak
13. Feeling burnt out, having hit rock-bottom
14. Decrease in beard growth

15. Decrease in the number of morning erections

16. Decrease in ability/frequency to perform sexually
17. Decrease in sexual desire/libido (lacking pleasure in sex, lacking desire for intercourse)

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Proper treatment can dramatically improve your life!

Call 646-380-2600 to schedule an appointment or learn more about Low T.


Last updated: February 2020