andropause is a condition of decreasing testosterone in men that usually begins to occur at about 40 years of age
. many men also find it difficult to acknowledge there may be a problem by refusing to even talk about the symptoms .
ignorance and fear of the andropause condition abounds in the general public and even among health professionals .
over 10,000 articles on climacteric ( or menopause ) for women can be found but relatively less has been conducted on the male equivalent .
attaining knowledge regarding andropause will help the caregivers and gerontologists to achieve the ultimate goal of a dignified healthy ageing and maintain the highest quality of life .
thus , it 's adding life to years and not simply years to life while ignorance about andropause persists , having an instrument turns out to be a necessity .
the study was investigated to the standards of massq ( 2012 ) within male older adults to introduce a relevant criterion .
about 382 men with age range of 50 - 80 and with the mean age of 65.3  2.32 were sampled with the cluster - ratio sampling method from the eight cities of khuzestan province in southwestern iran ( n = 228784 aged persons in the province ) [ appendix 1 ] .
the massq questionnaire mainly consists of a 25-item disability / symptom scale regarding andropause that was investigated by authors and literature reviews .
each item in the disability / symptom scale has five response options from 1 = none to 5 = extremely severe . if the 25 items are completed , a scale score ranging from 25 ( no symptoms ) to 125 ( most severe symptoms ) can be calculated .
the questionnaire was translated into persian from its english version by three instructors and an english language expert .
the four translated versions were compared by the authors , and the researchers developed a common persian text from them .
afterward , the persian version of the massq was translated back into english by an english language expert who had not seen the original english text and by a linguist .
the english statements of the questionnaire that had been translated from persian into english were compared with the original version , and any necessary revisions were made as well . from the eight cities of khuzestan province in southwestern iran ,
that is , ahwaz , behbahan , dezful , shoushtar , abadan , mah - shahr , masjid soleiman , and ramhormoz , about 400 aged men responded to the iranian version of the massq .
of the 400 responders , 382 had responded to all of the 25 items used in the massq and were included in the analysis .
the mean age of the samples was 65.3  2.32 ( range : 54 - 86 ) years .
the questionnaire was translated into persian from its english version by three instructors and an english language expert .
the four translated versions were compared by the authors , and the researchers developed a common persian text from them .
afterward , the persian version of the massq was translated back into english by an english language expert who had not seen the original english text and by a linguist .
the english statements of the questionnaire that had been translated from persian into english were compared with the original version , and any necessary revisions were made as well .
from the eight cities of khuzestan province in southwestern iran , that is , ahwaz , behbahan , dezful , shoushtar , abadan , mah - shahr , masjid soleiman , and ramhormoz , about 400 aged men responded to the iranian version of the massq .
of the 400 responders , 382 had responded to all of the 25 items used in the massq and were included in the analysis .
the mean age of the samples was 65.3  2.32 ( range : 54 - 86 ) years .
coefficients of cronbach 's alpha (  = 0.89 ) , split - half ( 0.91 ) , convergent validity ( 0.72 ) , divergent validity ( -0.32 ) criterion validity ( 0.67 ) were estimated , which were significant at p < 0.01 .
the exploratory factor analysis demonstrated that the 25-items of massq for aged samples are organized into four factors ( factor 1 : sexual , factor 2 : somatic , factor 3 : psychic , and factor 4 : behavioral ) which clarify 83% of the scale 's variance .
second - order confirmatory factor analysis pointed out that the factors were well matched up onto a principal factor . according to the table 1 ,
the rotated factor matrix pattern of varimax for the massq 's subscale questions was considered .
varimax - rotated factors matrix of the massq consequently , the four - factor model was appropriate for the data and the fit index techniques for adjusting the scale .
the indexes of the model 's goodness of fit refer to the integrity of the four - factor model with data .
the root mean square error of approximation ( rmsea ) and standardized root mean residual ( srmr ) must be less than 0.05 that indicate to good models .
the model pointed out the goodness of fit of the model in the study ( agfi = 0.92 , gfi = 0.91 , rmsea = 0.006 , ifi = 0.94 , nfi = 0.91 , cfi = 0.97 ) .
as closer measure to 1 in the normed fit index ( nfi ) , the comparative fit index ( cfi ) , goodness - of - fit statistic ( gfi ) , the incremental fit index ( ifi ) , and the adjusted goodness of fit index ( agfi ) , they refer to the goodness and fit of model .
the aim of the study is to look for the relevant instrument regarding common symptoms of an aged - related issue called andropause within aged males in the iranian social context , even the issue still is challengeable .
so , the andropause symptoms self - assessment questionnaire ( massq , 2012 ) was used and evaluated .
the results stated to the well - adjusted reliability and validity of massq and usefulness of it in the relevant studies as well .
therefore , future researchers should not limit themselves to the western scales but should also consider specific cultural factors .
additionally , it is suggested that in future studies , the female menopause symptoms self - assessment questionnaire , which are compatible with iran 's native culture , be conducted and evaluated as well .
validity and reliability in the aged male community of the iranian society and it can be employed to measure andropause symptoms .
it is applicable by gerontologists for the future studies as well as to the geriatrics in their diagnostics .
ethical matters , for example , plagiarism , uninformed consent , misconduct , data fabrication and/or falsification , double publication and/or submission , redundancy , and so on , have been totally observed by the authors .
ethical matters , for example , plagiarism , uninformed consent , misconduct , data fabrication and/or falsification , double publication and/or submission , redundancy , and so on , have been totally observed by the authors .
 background : andropause is a condition of decreasing testosterone in men that usually begins to occur at about 40 years of age . 
 many men find it difficult to acknowledge there may be a problem by refusing to even talk about the symptoms.aims:the study was conducted to the standards of massq ( 2012 ) within male older adults to introduce a relevant criterion.materials and methods : about 382 men with age range of 50 - 80 and with the mean age of 65.3  2.32 were sampled with the cluster - ratio sampling method from the eight cities of khuzestan province in southwestern iran . 
 the aged samples replied to the 25 items of massq.results:coefficients of cronbach 's alpha (  = 0.89 ) , split - half ( 0.91 ) , convergent validity ( 0.72 ) , divergent validity ( 0.32 ) , and criterion validity ( 0.67 ) were estimated , which were significant at p < 0.01 . 
 the exploratory factor analysis demonstrated that the 25-items of massq for aged samples are organized into four factors ( sexual , somatic , psychic , and behavioral ) which clarify 79% of the scale 's variance . 
 second - order confirmatory factor analysis pointed out that the factors are well - matched up onto a principal factor . 
 consequently , the four - factor model was well appropriate for the data by the fit index techniques for adjusting the scale [ adjusted goodness of fit index = 0.92 , goodness - of - fit statistic = 0.91 , root mean square error of approximation = 0.006 , incremental fit index = 0.94 , normed fit index = 0.91 , comparative fit index = 0.97].conclusions : the results pointed to the well - adjusted reliability and validity of massq and its usefulness for the relevant studies as well . 
INTRODUCTION
MATERIALS AND METHODS
Translating the instrument
Setting and participants
RESULTS
DISCUSSION AND CONCLUSION
Ethical considerations