Hypogonadism-related symptoms: development and evaluation of an empirically derived self-rating instrument (HRS 'Hypogonadism Related Symptom Scale').

While self-report screening instruments are highly sensitive to hypogonadism in the ageing male, they have lacked specificity as evidenced by low or absent correlations with testosterone. The purpose of this paper was to develop an economical and specific screening instrument for identifying hypogonadal ageing men. Based on a comprehensive study of physical, somatoform and affective complaints, sexual behaviour and function and hormonal parameters of 263 outpatients aged 40 years and above (M = 56.2; 40-84 years) recruited from six andrological outpatient departments in Germany, we identified those items correlating significantly with testosterone. By factor analyses, five factors were identified: 'reduced activity', 'dissatisfaction with sexual function', 'negative self-concept of physical fitness', 'reduced sexual desire' and 'hot flushes'. The corresponding scales were reliable and only moderately inter-correlated. Consistent correlations were found with the level of testosterone, ageing male scales (Androgen Deficiency in the Aging Male, Aging Male Survey), specific affective, somatoform and sexual functioning scales and potential determinants of low testosterone (body mass index, physical inactivity, etc.). While further validation is needed, the new Hypogonadism Related Symptoms Scale appears to be a promising hypogonadism screening tool.