Men's Health

Over the past six months:

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

Very Low
Low
Moderate
High
Very High

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 (much less than half the time)
Sometimes (about half the time)
Most times (much more than half the time)
Almost always/always

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/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/always

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

Did not attempt intercourse
Extremely difficult
Very difficult
Difficult
Slightly difficult
Not difficult

When you attempted sexual intercourse, how often was it satisfactory for you?

Did not attempt intercourse
Almost never/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/always

Score  

If your score is 20 and below, you may have erectile dysfunction.




* Please see your doctor for further evaluation. Erectile dysfunction is easily treatable.
This questionnaire is not intended as a substitute for professional care, only your doctor can diagnose and treat a medical problem.