Erectile Dysfunction Test

Each question has several possible responses. Please circle the number of the response that best describes your own situation. Make sure that you select only one response for each question.

Over the past 6 months:

1. How do you rate your confidence that you could get and keep an erection?

Very Low	Low	Moderate	High	Very High
1	2	3	4	5

 
2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration (entering your partner)?

No Sexual Activity	Almost never or 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 or always
0	1	2	3	4	5

 
3. During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?

Did not attempt intercourse	Almost never or 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 or always
0	1	2	3	4	5

 
4. During sexual intercourse, how difficult was it maintain your erection to completion of intercourse?

Did not attempt intercourse	Extremely difficult		Very difficult	Difficult	Slightly difficult	Not difficult
0	1	2		3	4	5

 
5. When you attempted sexual intercourse, how often was it satisfactory to you?

Did not attempt intercourse	Almost never or 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 or always
0	1	2	3	4	5

Score ____________

Add the numbers corresponding to questions 1 through 5. If your score is 21 or less, you may want to talk to your doctor.

Adapted from Rosen RC, et al. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319-326

Copyright 2008 © Urology Centers of Alabama. All rights reserved. Privacy Policy  Site by Zeekee Interactive