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Questions: Based on last 6 months (each answer assigned 1-5 score)
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1. How do you rate your confidence that you could get and keep an erection?
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2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration?
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3. During sexual intercourse, how often were you able to maintain your erections after you had penetrated or entered your partne
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4. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
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5. When you attempted sexual intercourse, how often was it satisfactory for you?
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Interpretation: Based on total sum of scores from 5 questions above
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Your Score: __
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1. Scores 22 to 25: Normal
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2. Scores 17 to 21: Mild
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3. Scores 12 to 16: Mild to Moderate
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4. Scores 8 to 11: Moderate
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5. Scores 1 to 7: Severe
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