Erectile dysfunction problem always upsetting someone who suffering from. This condition is not only affecting the gentlemen but also making a very compromising on their partners. Urologist In-charge must complete all the essential history taking, physical examination and proper investigations. Today I will show you a well-constructed questionnaire in erectile dysfunction assessment, IIEF-EF or International Index of Erectile Function – Erection Function.
| Name of patient | ______________________________________ |
| Date of doing the questionaire | ______________________________________ |
| Date of birth | ______________________________________ |
These questions asking about the effects that your erectile dysfunction problems impact on your sexual condition over the last four weeks. Please try to answer the questions honestly and clearly as good as you can.
Erectile dysfunction IIEF-EF Questionnaire
- How often were you able to get erection during sexual activity? (Choose one answer below)
| a. No sexual activity |
| b. Almost never or never |
| c. A few times (less than half the time) |
| d. Sometimes (about half the time) |
| e. Most of the times (more than half times) |
| f. Almost always or always |
- When you had erections with sexual stimulation, how often were your erections hard enough for penetration? (Choose one answer below)
| a. No sexual activity |
| b. Almost never or never |
| c. A few times (less than half the time) |
| d. Sometimes (about half the time) |
| e. Most of the times (more than half times) |
| f. Almost always or always |
- When you attempted to intercourse, how often were you able to penetrate (insert) your partner? (Choose one answer below)
| a. No sexual activity |
| b. Almost never or never |
| c. A few times (less than half the time) |
| d. Sometimes (about half the time) |
| e. Most of the times (more than half times) |
| f. Almost always or always |
- During sexual intercourse, how often were you able to maintain your erection after you had penetrated (insert) your partner? (Choose one answer below)
| a. No sexual activity |
| b. Almost never or never |
| c. A few times (less than half the time) |
| d. Sometimes (about half the time) |
| e. Most of the times (more than half times) |
| f. Almost always or always |
- During sexual intercourse, how difficult was it to maintain your erection to complete intercourse? (Choose one answer below)
| a. No sexual activity |
| b. Almost never or never |
| c. A few times (less than half the time) |
| d. Sometimes (about half the time) |
| e. Most of the times (more than half times) |
| f. Almost always or always |
- How do you rate your confidence in term of remaining and keeping your erection? (Choose one answer below)
| a. Very low |
| b. Low |
| c. Moderate |
| d. High |
| e. Very high |
Total Erection function domains
| Score | ______________________________________ |
Those are all of the Erectile dysfunction IIEF-EF Questionnaire. You can visit my official homepage here.
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