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Anti-Aging questionnaire for men
1. Have you experienced a loss of muscle mass?
Yes
No
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2. Do you have difficulty keeping fat off or do you store excess fat around your midsection?
Yes
No
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3. Are you losing your self-confidence?
Yes
No
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4. Have you lost interest in sex?
Yes
No
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5. Have you found it difficult to stay awake, need more sleep, or have less energy than when you were thirty?
Yes
No
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6. Are you feeling depressed or have you lost your edge?
Yes
No
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7. Do you have fewer erections in the morning or trouble getting an erection?
Yes
No
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8. During sexual intimacy, is your erection less rigid or hard?
Yes
No
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9. Do you have thinner, blemished, or sagging skin?
Yes
No
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10. Are you more irritable? Is some of your zest for life fading?
Yes
No
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11. Have you recently noticed difficulty concentrating or forgetfulness when trying to remember names and places?
Yes
No
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12. Have you been experiencing more stress, anxiousness, or nervousness?
Yes
No
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13. Have you gained weight, especially in the abdomen, (or clothes not fitting/too tight)?
Yes
No
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14. Are you slower, more sluggish, or do you have less energy?
Yes
No
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