International Index Of Erectile Function
Questionaire

Erectile Function Questionaire<<

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(Note your answers and add up the total).

The first five questions refer to erectile function

Erectile Function Questionaire

1. Over the last month, how often were you able to get an erection during sexual activity?

  • 0 No sexual activity
  • 5 Almost always or always
  • 4 Most times (much more than half the time)
  • 3 Sometimes (about half the time)
  • 2 A few times (much less than half the time)
  • 1 Almost never or never
  • Q2. Over the last month, when you had erections with sexual stimulation, how often were your erections hard enough for penetration?

  • 0 No sexual activity
  • 5 Almost always or always
  • 4 Most times (much more than half the time)
  • 3 Sometimes (about half the time)
  • 2 A few times (much less than half the time)
  • 1 Almost never or never
  • Q3. Over the last month, when you attempted intercourse, how often were you able to penetrate your partner?

  • 0 No sexual activity
  • 5 Almost always or always
  • 4 Most times (much more than half the time)
  • 3 Sometimes (about half the time)
  • 2 A few times (much less than half the time)
  • 1 Almost never or never
  • Q4. Over the last month, during sexual intercourse, how often were you able to maintain your erection after you had pentrated your partner?

  • 0 No sexual activity
  • 5 Almost always or always
  • 4 Most times (much more than half the time)
  • 3 Sometimes (about half the time)
  • 2 A few times (much less than half the time)
  • 1 Almost never or never
  • Q5. Over the last month, during sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?

  • 0 No sexual activity
  • 1 Extremely difficult
  • 2 Very difficult
  • 3 Difficult
  • 4 Slightly difficult
  • 5 Not difficult
  • Your Score For This Section_____

    Erectile Function Questionaire

    The next three questions refer to satisfaction with intercourse

    Q6. Over the last month, how many times have you attempted sexual intercourse?

  • 0 No attempts
  • 1 1-2 times
  • 2 3-4 times
  • 3 5-6 times
  • 4 7-10 times
  • 5 11-20 times
  • Q7. Over the last month, when you attempted sexual intercourse how often was it satisfactory for you?

  • 0 Did not attempt intercourse
  • 5 Almost always or always
  • 4 Most times (much more than half the time)
  • 3 Sometimes (about half the time)
  • 2 A few times (much less than half the time)
  • 1 Almost never or never
  • Q8. Over the last month, how much have you enjoyed sexual intercourse?

  • 0 No intercourse
  • 5 Very highly enjoyable
  • 4 Highly enjoyable
  • 3 Fairly enjoyable
  • 2 Not very enjoyable
  • 1 No enjoyment
  • Your Score For This Section_____

    Erectile Function Questionaire

    The next two questions refer to orgasmic function

    Q9. Over the last month, when you had sexual stimulation or intercourse, how often did you ejaculate?

  • 0 No sexual stimulation/intercourse
  • 5 Almost always or always
  • 4 Most times (much more than half the time)
  • 3 Sometimes (about half the time)
  • 2 A few times (much less than half the time)
  • 1 Almost never or never
  • Q10. Over the last month, when you had sexual stimulation or intercourse, how often did you have the feeling of orgasm (with or without ejaculation)?

  • 0 No sexual stimulation/intercourse
  • 5 Almost always or always
  • 4 Most times (much more than half the time)
  • 3 Sometimes (about half the time)
  • 2 A few times (much less than half the time)
  • 1 Almost never or never
  • Your Score For This Section_____

    Erectile Function Questionaire

    The next two questions ask about sexual desire.
    In this context, sexual desire is defined as a feeling that may include wanting to have a sexual experience (for example masturbation or sexual intercourse), thinkingabout having sex, or feeling frustrated due to lack of sex.

    Q11. Over the last month, how often have you felt sexual desire?

  • 5 Almost always or always
  • 4 Most times (much more than half the time)
  • 3 Sometimes (about half the time)
  • 2 A few times (much less than half the time)
  • 1 Almost never or never
  • Q12. Over the last month, how would you rate your level of sexual desire?

  • 5 Very high
  • 4 High
  • 3 Moderate
  • 2 Low
  • 1 Very low or not at all
  • Your Score For This Section_____

    Erectile Function Questionaire

    The next two questions refer to overall sexual satisfaction.

    Q13. Over the last month, how satisfied have you been with your overall sex life?

  • 5 Very satisfied
  • 4 Moderately satisfied
  • 3 About equally satisfied and dissatisfied
  • 2 Moderately dissatisfied
  • 1 Very dissatisfied
  • Q14. Over the last month, how satisfied have you been with your sexual relationshipwith your partner?

  • 5 Very satisfied
  • 4 Moderately satisfied
  • 3 About equally satisfied and dissatisfied
  • 2 Moderately dissatisfied
  • 1 Very dissatisfied
  • Your Score For This Section_____

    Erectile Function Questionaire

    The last question refers to erectile function

    Q15. Over the last month, how do you rate your confidence that you can get andkeep your erection?

  • 5 Very high
  • 4 High
  • 3 Moderate
  • 2 Low
  • 1 Very low
  • Your Score For This Section_____

    Your Total Score _____

    What the Scores Mean

    21-30 No Erectile Dysfunction

    11-20 Moderate ED

    0-10 High Level ED