International Society for the Study of the Aging Male(ISSAM)

The aging males' symptoms (AMS) rating scale

The interest in clinically investigating the health-related quality of life (HRQoL) and symptoms of aging men has increased in recent years. To this end the Aging Males' Symptom Scale (AMS) was developed to (a) assess symptoms of aging (independent from those which are disease-related) between groups of males under different conditions, (b) to evaluate the severity of symptoms over time, and (c) to measure changes pre- and post androgen replacement therapy. It was developed in response to the lack of standardized scales to measure the severity of aging symptoms and their impact on HRQoL in males, specifically2.

The AMS scale was originally developed & standardized in Germany in accordance with rules for psychometric tests. The scale was first translated into English (valid also for North America). Thereafter, the AMS was translated into various languages including Dutch, French, Flemish, Finnish, Indonesian, Italian, Japanese, Korean, Thai (in process), Portuguese, Russian, Spanish, and Swedish3. Most of them had been established according to state-of-the -art methodology4 and were used in clinical research.

Test-retest comparisons of the final scales' total scores' were done in many countries and showed sufficient reliability with correlation coefficients ranging from r= 0.80 to r= 0.93.

Investigations on different kinds of validity have been successfully done or are underway: comparisons with another QoL scale, another aging male symptom scale, and confirmation of effects of hormone substitution in hypogonadal men.

Reference values
Reference values for the normal population were published for the normal German population, work in other countries will follow, although reference values may not deviate substantially from the German ones, but it is important to provide evidence to support this assumption.

Application and evaluation of the AMS
The scale is a self-administered questionnaire. The answer categories of all 17 questions are given as scoring points. All scoring points will be added up to produce the total sum-score. The same procedure is possible for the three sub-categories consisting of a defined set of items (see attached evaluation form).

The AMS scale is a valuable tool for assessing health related quality of life and symptoms in aging men and used worldwide. Evidence of its psychometric properties are available. Clinical trials of hormone treatment using the AMS as end-point are under way.

AMS Website (for AMS in different languages, click on Languages link)
AMS Questionnaire
AMS Rating Scale - Evaluation Form

Further details can be obtained from the author of the scale:
Lothar A.J. Heinemann, M.D., D.Sc., Dipl. Psych., Professor for Preventive Medicine, ZEG - Centre for Epidemiology & Health Research Berlin, Invalidenstrasse 115, 10115 Berlin - Germany. Tel: (+49.30) 9451.0124;
Fax: (+49.30) 9451.0126; e-mail:

  1. Heinemann LAJ, Zimmermann T, Vermeulen A, Thiel C. A New 'Aging Male's Symptoms' (AMS) Rating Scale. The Aging Male 1999; 2:105-114.

  2. Heinemann LAJ, Saad F, P?ll?nen P. Measurement of Quality of Life Specific for Aging Males. In: Schneider HPG (Ed.) Hormone Replacement Therapy and Quality of Life. Parthenon Publishing Group. London, New York, Washington. 2002: 63-83

  3. Heinemann LAJ, Saad F, Zimmermann T, Novak A, Myon E, Badia X, Potthoff P, T'Sjoen G, P?ll?nen P, Goncharow NP, Kim S, Giroudet Ch.The Aging Males' Symptoms (AMS) rating scale: Update and compilation of international versions. Health and Quality of Life Outcome (submitted for publication).

  4. Medical Outcomes Trust introduces new translation criteria. Medical Outcomes Trust Bulletin 1997; 5(4):2-4


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