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ERECTILE DISFUCTION

Chose the most accurate answer for each question.

OVER THE LAST SIX (6) MONTHS:

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

Not possible

Very low

Low

Moderate

High

Very high

2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration?

Never

Almost never

Much less than half the time

About half the time

Much more than half the time

Almost always or always

3. During sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner?

Never

Almost never

Much less than half the time

About half the time

Much more than half the time

Almost always or always

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

Impossible

Extremely difficult

Very difficult

Difficult

Slightly difficult

Not difficult

5. when you attempted sexual intercourse, how often was it satisfactory for you?

Never

Almost never

Much less than half the time

About half the time

Much more than half the time

Almost always or always

0

1

2

3

4

5

Add up your points. If your score is less that 21 you do have signs of erectile dysfunction and must see your urologist.