This questionnaire is used to determine whether erectile dysfunction is present. This form inquires about five key aspects of male sexual dysfunction: the ability to achieve and maintain an adequate erection, the level of sexual satisfaction, and the effectiveness of a specific treatment. The form aims to provide a reliable reflection of sexual function.

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1.) How often did you experience an erection during sexual activity in the last 4 weeks?

2.) What proportion of sexually aroused erections during the last 4 weeks were sufficient to enable sexual intercourse?

3.) How often was penetration possible during sexual intercourse attempts in the last 4 weeks?

4.) How often have you been able to maintain erection during sexual intercourse in the last 4 weeks?

5.) How much difficulty did you have in maintaining an erection to complete sexual intercourse during the last 4 weeks?

6.) How many times have you attempted sexual intercourse in the last 4 weeks?

7.) How often were you satisfied with your sexual intercourse attempts in the last 4 weeks?

Form

About the Erectile Function Test

Erectile function testing is one of the most common methods used to assess sexual dysfunction in men. This assessment is typically conducted using the International Index of Erectile Function (IIEF) questionnaire. The IIEF was developed by Dr. Raymond Rosen and his team in 1997 and has gained widespread acceptance within the scientific community. The questionnaire comprehensively assesses men's sexual function, helping to identify potential problems.

Purpose of This Form

The IIEF questionnaire is designed to objectively measure individuals' status in critical areas, particularly erectile function and sexual satisfaction. Questions in the questionnaire provide information to assess a patient's ability to achieve and maintain a firm erection, their level of satisfaction with sexual intercourse, and the effectiveness of treatment methods.

The survey focuses on five key issues:

1. Adequacy of erection
2. Duration of maintaining erection
3. Level of sexual satisfaction
4. Orgasm quality
5. Overall sexual satisfaction

Classification of Erectile Dysfunction (ED)

The survey's six questions about erectile function (questions 1, 2, 3, 4, 5, and 15) are used to determine the severity of erectile dysfunction (ED). Responses to these questions are evaluated using a specific scoring system:

• “None or almost none”: 1 point
• “Rarely”: 2 points
• “Sometimes”: 3 points
• “Mostly”: 4 points
• “Always”: 5 points

The total score obtained is used to classify the severity of erectile dysfunction:

Erectile Function Score Erectile Dysfunction Classification
6-10 Severe ED
11-16 Medium ED
17-25 Mild ED
26-30 no ED

Importance of Survey Responses

The questions in this questionnaire ask about changes in your sexual life over the past four weeks. Your honest and clear answers will help your doctor determine the most appropriate treatment option for you. Your answers will be evaluated only by your doctor, and your confidentiality will be protected.