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
2. When you had erections with sexual stimulation‚how often were your erections hard enough for penetration?
· 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
3. During sexual intercourse‚ how often wereyou able to maintain your erection after you had penetrated your partner?
· Almost never of 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
4. During sexual intercourse‚ how difficult was it to maintain your erection to completion of intercourse?
· Extremely difficult
· Very difficult
· Difficult
· Slightly difficult
· Not difficult
5. When you attempted sexual intercourse‚ how often was it satisfactory for you?
· 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
ED: Erectile Dysfunction ; 1-7: Severe ED 8-11: Moderate ED 12-16: Mild-moderate ED 17-21: Mild ED 22-25: No ED
Rosen‚ R.C.‚ Cappelleri‚ J.C.‚ Smith‚ M.D.‚ Lipsky‚ J.‚ Pena‚ B.M. (1999). 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. International Journal of Impotence Research; 11(6): 319 – 326.
Rosen‚ R.C.‚ Althof‚ S.E.‚ Giuliano‚ F. (2006). Research instruments for the diagnosis and treatment of patients with erectile dysfunction. Urology‚ 68: 6-16.
Rhoden‚ E.L.‚ Teloken‚ C.‚ Sogari‚ P.R.‚ Vargas‚ S.C. (2002).The use of the simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. Int J Impot Res.‚ 14: 245-250.
