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Erectile dysfunction, also known as impotence, is a common medical condition affecting sexual health. However, the frequency and duration of erections vary normally within a man's life without being a problem in itself. This questionnaire is designed to help you identify if you may be experiencing erectile dysfunction.
The following questions cover the last six months. For each question, circle the value that matches your answer.
Over the past six months...
| Question 1 - | How do you rate your confidence that you could get an erection?
- Very Low
- Low
- Moderate
- High
- Very high
|
| Question 2 - | When you had erections with sexual stimulation, how often were your erections hard enough for penetration?
- No sexual activity
- Almost never/Never
- A few times
- Sometimes
- Most times
- Almost always/Always
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| Question 3 - | During sexual intercourse, how often were you able to maintain your erection intercourse after you had penetrated (entered) your partner?
- Did not attempt
- Almost never/Never
- A few times
- Sometimes
- Most times
- Almost always/Always
|
| Question 4 - | During sexual intercourse, how difficult was it to maintain your erection to intercourse completion of intercourse?
- Did not attempt
- Extremely difficult
- Very difficult
- Difficult
- Slightly difficult
- Not difficult
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| Question 5 - | When you attempted sexual intercourse, how often was it satisfactory to you?
- Did not attempt
- Almost never/Never
- A few times
- Sometimes
- Most times
- Almost always/Always
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