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Tsertsvadze A, Yazdi F, Fink HA, et al. Diagnosis and Treatment of Erectile Dysfunction. Rockville (MD): Agency for Healthcare Research and Quality (US); 2009 May. (Evidence Reports/Technology Assessments, No. 171.)

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Diagnosis and Treatment of Erectile Dysfunction.

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Appendix H. Instruments Used in the Assessment of Treatment Outcomes

International Index of Erectile Function (IIEF)

Individual items of International Index of Erectile Function Questionnaire and response options (US version)*:

Q1: How often were you able to get an erection during sexual activity?

0 = No sexual activity

1 = Almost never/never

2 = A few times (much less than half the time)

3 = Sometimes (about half the time)

4 = Most times (much more than half the time)

5 = Almost always/always

Q2: When you had erections with sexual stimulation, how often were your erections hard enough for penetration?

0 = No sexual activity

1 = Almost never/never

2 = A few times (much less than half the time)

3 = Sometimes (about half the time)

4 = Most times (much more than half the time)

5 = Almost always/always

Q3: When you attempted sexual intercourse, how often were you able to penetrate (enter) your partner?

0 = Did not attempt intercourse

I = Almost never/never

2 = A few times (much less than half the time)

3 = Sometimes (about half the time)

4 = Most times (much more than half the time)

5 = Almost always/always

Q4: During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?

0 = Did not attempt intercourse

I = Almost never/never

2 = A few times (much less than half the time)

3 = Sometimes (about half the time)

4 = Most times (much more than half the time)

5 = Almost always/always

Q5: During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?

0 = Did not attempt intercourse

1 = Extremely difficult

2 = Very difficult

3 = Difficult

4 = Slightly difficult

5 = Not difficult

Q6: How many times have you attempted sexual intercourse?

0 = No attempts

1 = One to two attempts

2 = Three to four attempts

3 = Five to six attempts

4 = Seven to ten attempts

5 = Eleven+ attempts

Q7: When you attempted sexual intercourse, how often was it satisfactory for you?

0 = Did not attempt intercourse

1 = Almost never/never

2 = A few times (much less than half the time)

3 = Sometimes (about half the time)

4 = Most times (much more than half the time)

5 = Almost always/always

Q8: How much have you enjoyed sexual intercourse?

0 = No intercourse

1 = No enjoyment

2 = Not very enjoyable

3 = Fairly enjoyable

4 = Highly enjoyable

5 = Very highly enjoyable

Q9: When you had sexual stimulation or intercourse, how often did you ejaculate?

0 = No sexual stimulation/intercourse

1 = Almost never/never

2 = A few times (much less than half the time)

3 = Sometimes (about half the time)

4 = Most times (much more than half the time)

5 = Almost always/always

Q10: When you had sexual stimulation or intercourse, how often did you have tile feeling of orgasm or climax?

0 = No sexual stimulation/intercourse

1 = Almost never/never

2 = A few times (much less than half the time)

3 = Sometimes (about half the time)

4 = Most times (much more than half the time)

5 = Almost always/always

Q11: How often have you felt sexual desire?

1 = Almost never/never

2 = A few times (much less than half the time)

3 = Sometimes (about half the time)

4 = Most times (much more than half the time)

5 = Almost always/always

Q12: How would you rate your level of sexual desire?

1 = Very low/none at all

2 = Low

3 = Moderate

4 = High

5 = Very high

Q13: How satisfied have you been with your overall sex life?

1 = Very dissatisfied

2 = Moderately dissatisfied

3 = About equally satisfied and dissatisfied

4 = Moderately satisfied

5 = Very satisfied

Q14: How satisfied have you been with your sexual relationship with your partner?

1 = Very dissatisfied

2 = Moderately dissatisfied

3 = About equally satisfied and dissatisfied

4 = Moderately satisfied

5 = Very satisfied

Q15: How do you rate your confidence that you could get and keep an erection?

1 = Very low

2 = Low

3 = Moderate

4 = High

5 = Very high

IIEF domains and the scoring

DomainItemsScore RangeMinimum ScoreMaximum Score
Erectile Function1,2, 3, 4, 5, 150 (or 1)–5130
Orgasmic Function9, 100–5010
Sexual Desire11, 121–5210
Intercourse Satisfaction6, 7, 80–5015
Overall Satisfaction13, 141–5210

IIEF-5 scoring system

QuestionScore
Over the past six months:12345
How do you rate your confidence that you could get and keep an erection?Very lowLowModerateHighVery high
When you had erections with sexual stimulation, how often were your erections hard enough for penetration?Almost never or neverMuch less than half the timeAbout half the timeMuch more than half the timeAlmost always or always
During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?Almost never or neverMuch less than half the timeAbout half the timeMuch more than half the timeAlmost always or always
During sexual intercourse how difficult was it to maintain your erection to the completion of intercourse?Extremely difficultVery difficultDifficultSlightly difficultNot difficult
When you attempted sexual intercourse, how often was it satisfactory for you?Almost never or neverMuch less than half the timeAbout half the timeMuch more than half the timeAlmost always or always
The IIEF-5 score is the sum of questions 1 to 5. The lowest score is 5 and the highest score 25.

Sexual Encounter Profile (SEP- Questions 2 and 3)

SEP-Q2: Were you able to insert your penis into your partner's vagina?

SEP-Q3: Did your erection last long enough for you to have successful intercourse?

Global Assessment Question (GAQ)

GAQ-Q1: Has the treatment you have been taking improved your erectile function?

GAQ-Q2: If yes, has the treatment improved your ability to engage in sexual activity?

All questions are preceded by the phrase “Over the past 4 weeks.”

Footnotes

*

All questions are preceded by the phrase “Over the past 4 weeks.”

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