


September 2010, 8^th

International Index for Erectile Function

Over the past 4 weeks during sexual activity

1. How often were you able to get an erection during sexual activity?
	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
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 (much less than half the time)
	Sometimes (about half the time)
	most times (much more than half the time)
	Almost always/always
3. When you attempted sexual intercourse, how often were you able to penetrate (enter)?
	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
4. During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) you 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
5. During sexual intercourse, how difficult was is to maintain your erection to complete intercourse?
	Did not attempt intercourse
	Extremely difficult
	Very difficult
	Difficult
	Slightly difficult
	Not difficult
6. How many times have you attempted sexual intercourse?
	No attempts
	One to two attempts
	Three to four attempts
	Five to six attempts
	Seven to ten attempts
	Eleven+ attempts
7. When you attempted sexual intercourse, how often was it satisfactory to 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
8. How much have you enjoyed sexual intercourse?
	No intercourse
	No enjoyment
	Not very enjoyable
	Fairly enjoyable
	Highly enjoyable
	Very highly enjoyable
9. When you had sexual stimulation or intercourse, how often did you ejaculate?
	No sexual stimulation/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
10. When you had sexual stimulation or intercourse, how often did you have the feeling of orgasm or climax?
	No sexual stimulation/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
11. How often have you felt sexual desire?
	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
12. How would you rate your level of sexual desire?
	Very low/none at all
	Low
	Moderate
	High
	Very high
13. How satisfied have you been with your overall sex life?
	Very dissatisfied
	Moderately dissatisfied
	About equally satisfied and dissatisfied
	Moderately satisfied
	Very satisfied
14. How satisfied have you been with your sexual relationship with your partner?
	Very dissatisfied
	Moderately dissatisfied
	About equally satisfied and dissatisfied
	Moderately satisfied
	Very satisfied
15. How do you rate your confidence that you could get and keep an erection?
	Very low
	Low
	Moderate
	High
	Very high
Your age