International Index of Erectile Function Questionnaire IIEF

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International Index of Erectile Function Questionnaire IIEF Instructions: These questions ask about the effects your erections have had on your sex life, over the past 4 weeks. Please answer the following questions as honestly and clearly as possible. In answering these questions, the following definitions apply: Definitions: Sexual activity includes intercourse, caressing, foreplay and masturbation Sexual intercourse is defined as vaginal penetration of the partner (you entered the partner) Sexual stimulation includes situations like foreplay with a partner, looking at erotic pictures, etc. Ejaculate is defined as the ejection of semen from the penis (or the feeling of this) International Index of Erectile Function (IIEF) Questionnaire* Name: Date: (Write the number that best describes your erectile function for the past 4 weeks in the spaces provided.) Over the past four weeks: 1. How often were you able to get an erection during sexual activity? 0 = No sexual activity 2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration? 0 = No sexual activity 3. When you attempted sexual intercourse, how often were you able to penetrate (enter) your partner?

4. During intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner? 5. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse? 1 = Extremely difficult 2 = Very difficult 3 = Difficult 4 = Slightly difficult 5 = Not difficult 6. How many times have you attempted sexual intercourse? 0 = No attempts 1 = One to two attempts 2 = Three to four attmepts 3 = Five to six attempts 4 = Seven to ten attempts 5 = Eleven or more attempts 7. When you attempted sexual intercourse, how often was it satisfactory for you? 8. How much have you enjoyed sexual intercourse? 0 = No intercourse 1 = No enjoyment 2 = Not very enjoyable 3 = Fairly enjoyable 4 = Highy enjoyable 5 = Very highly enjoyable 9. When you had sexual stimulation orintercourse, how often did you ejaculate? 0 = No sexual stimulation/intercourse 10. When you had sexual stimulation orintercourse, how often did you have the feeling of orgasm or climax? 0 = No sexual stimulation/intercourse 11. How often have you felt sexual desire?

12. How would you rate your sexual desire? 1 = Very low/none at all 2 = Low 3 = 4 = High 5 = Very high 13. How satisfied have you been with your overall sex life? 1 = Very dissatisfied 2 = ly dissatisfied 3 = About equally satisfied and dissatisfied 4 = ly satisfied 5 = Very satisfied 14. How satisfied have you been with yoursexual relationship with your partner? 1 = Very dissatisfied 2 = ly dissatisfied 3 = About equally satisfied and dissatisfied 4 = ly satisfied 5 = Very satisfied 15. How would you rate your confidence that you could get and keep an erection? 1 = Very low 2 = Low 3 = 4 = High 5 = Very high All items are scored in 5 domains as follows: Domain Items Range Max Erectile Function 1, 2, 3, 4, 5, 15 0-5 30 Orgasmic Function 9, 10 0-5 10 Sexual Desire 11, 12 0-5 10 Intercourse Satisfaction 6, 7, 8 0-5 15 Overall Satisfaction 13, 14 0-5 10 I. Erectile function total scores can be interpreted as follows: 0-6 Severe 7-12 13-18

19-24 Mild 25-30 No II. Orgasmic function total scores can be interpreted as follows: 0-2 3-4 Severe 7-8 Mild 9-10 No III. Sexual desire total scores can be interpreted as follows:. 0-2 3-4 Severe 7-8 Mild 9-10 No IV. Intercourse satisfaction total scores can be interpreted as follows:

0-3 Severe 4-6 7-9 10-12 Mild 13-15 No V. Overall satisfaction total scores can be interpreted as follows: 0-2 Severe 3-4 7-8 Mild 9-10 No