A Questionnaire To Evaluate Erectile Dysfunction: Mens Sexual Health
Content provided by the Faculty of the Harvard Medical School
A questionnaire to evaluate erectile dysfunction
Your doctor or other health professional may use this questionnaire or one like it to evaluate erectile dysfunction. The test is usually given before treatment begins and at appropriate intervals during and after care to gauge the treatment's effectiveness. Try to answer all the questions as honestly as possible. Check only one answer for each question.
Before you beginWhen taking this test, keep the following definitions in mind.
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1. Over the past four weeks, how often were you able to get an erection during sexual activity?
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No sexual activity
-
Almost never/Never
-
A few times (much less than half the time)
-
Sometimes (about half the time)
-
Most times (much more than half the time)
-
Almost always/Always
2. Over the past four weeks, when you had erections with sexual stimulation, how often were your erections hard enough for penetration?
-
No sexual stimulation
-
Almost never/Never
-
A few times (much less than half the time)
-
Sometimes (about half the time)
-
Most times (much more than half the time)
-
Almost always/Always
3. Over the past four weeks, when you attempted sexual intercourse, how often were you able to penetrate (enter) your partner?
-
No intercourse
-
Almost never/Never
-
A few times (much less than half the time)
-
Sometimes (about half the time)
-
Most times (much more than half the time)
-
Almost always/Always
4. Over the past four weeks, during sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?
-
No intercourse
-
Almost never/Never
-
A few times (much less than half the time)
-
Sometimes (about half the time)
-
Most times (much more than half the time)
-
Almost always/Always
5. Over the past four weeks, during sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
-
No intercourse
-
Extremely difficult
-
Very difficult
-
Difficult
-
Slightly difficult
-
Not difficult
6. Over the past four weeks, how many times have you attempted sexual intercourse?
-
No attempts
-
1–2 attempts
-
3–4 attempts
-
5–6 attempts
-
7–10 attempts
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11 or more attempts
7. Over the past four weeks, when you attempted sexual intercourse, how often was it satisfactory for you?
-
No intercourse
-
Almost never/Never
-
A few times (much less than half the time)
-
Sometimes (about half the time)
-
Most times (much more than half the time)
-
Almost always/Always
8. Over the past four weeks, how much have you enjoyed sexual intercourse?
-
No intercourse
-
No enjoyment
-
Not very enjoyable
-
Fairly enjoyable
-
Highly enjoyable
-
Very highly enjoyable
9. Over the past four weeks, when you had sexual stimulation or intercourse, how often did you ejaculate?
-
No sexual stimulation/intercourse
-
Almost never/Never
-
A few times (much less than half the time)
-
Sometimes (about half the time)
-
Most times (much more than half the time)
-
Almost always/Always
10. Over the past four weeks, when you had sexual stimulation or intercourse, how often did you have an orgasm (with or without ejaculation)?
-
No sexual stimulation/intercourse
-
Almost never/Never
-
A few times (much less than half the time)
-
Sometimes (about half the time)
-
Most times (much more than half the time)
-
Almost always/Always
11. Over the past four weeks, how often have you felt sexual desire?
-
Almost never/Never
-
A few times (much less than half the time)
-
Sometimes (about half the time)
-
Most times (much more than half the time)
-
Almost always/Always
12. Over the past four weeks, how would you rate your level of sexual desire?
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Very low/None at all
-
Low
-
Moderate
-
High
-
Very high
13. Over the past four weeks, how satisfied have you been with your overall sex life?
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Very dissatisfied
-
Moderately dissatisfied
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About equally satisfied and dissatisfied
-
Moderately satisfied
-
Very satisfied
14. Over the past four weeks, how satisfied have you been with your sexual relationship with your partner?
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Very dissatisfied
-
Moderately dissatisfied
-
About equally satisfied and dissatisfied
-
Moderately satisfied
-
Very satisfied
15. Over the past four weeks, how would you rate your confidence that you could get and keep your erection?
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Very low/None at all
-
Low
-
Moderate
-
High
-
Very high
Source: International Index of Erectile Function (IIEF): A Multidimensional Scale for Assessment of Erectile Dysfunction.
Adapted with permission from Urology, published by Elsevier Science.
Calculating your score |
| For questions 1, 2, 3, 4, 7, 9, and 10, score as follows: 0 = No (sexual activity, stimulation, intercourse) 1 = Almost never/Never 2 = A few times (much less than half the time) 3 = Sometimes (about half the time) 4 = Most times (much more than half the time) 5 = Almost always/Always For question 5, score as follows: 0 = Did not attempt intercourse 1 = Extremely difficult 2 = Very difficult 3 = Difficult 4 = Slightly difficult 5 = Not difficult For question 6, score as follows: 0 = No attempts 1 = 1–2 attempts 2 = 3–4 attempts 3 = 5–6 attempts 4 = 7–10 attempts 5 = 11 or more attempts For question 8, score as follows: 0 = No intercourse 1 = No enjoyment 2 = Not very enjoyable 3 = Fairly enjoyable 4 = Highly enjoyable 5 = Very highly enjoyable For question 11, score as follows: 0 = Almost never/Never 2 = A few times (much less than half the time) 3 = Sometimes (about half the time) 4 = Most times (much more than half the time) 5 = Almost always/Always For questions 12 and 15, score as follows: 1 = Very low/None at all 2 = Low 3 = Moderate 4 = High 5 = Very high For questions 13 and 14, score as follows: 1 = Very dissatisfied 2 = Moderately dissatisfied 3 = About equally satisfied and dissatisfied 4 = Moderately satisfied 5 = Very satisfied |
| Add the scores for each of these questions to determine your total score. Compare your score before and after treatment begins to help determine the treatment's success. A higher score indicates improvement. For help in evaluating the success of the treatment, discuss your scores with your doctor or health care professional. |
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A questionnaire to evaluate erectile dysfunction: 1 of 1
| Last updated: | September 05, 2008 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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