The IIEF-5 Questionnaire (SHIM)

Score for Erectile Dysfunction

1-7: Severe
8-11: Moderate
12-16: Mild-moderate
17-21: Mild
22-25: No Erectile Dysfunction

Welcome to the International Index of Erectile Function (IIEF) Questionnaire

Please choose the response that best describes you over the past 6 months (5 questions):

Question Title

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

Very low

Low

Moderate

High

Very high

Question Title

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

Almost never or never

A few times (much less than half the time)

Sometimes (about half the time)

Most times (much more than half the time)

Almost always or always

Question Title

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

Almost never of never

A few times (much less than half the time)

Sometimes (about half the time)

Most times (much more than half the time)

Almost always or always

Question Title

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

Extremely difficult

Very difficult

Difficult

Slightly difficult

Not difficult

Question Title

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

Almost never or never

A few times (much less than half the time)

Sometimes (about half the time)

Most times (much more than half the time)

Almost always or always

The IIEF-5 Questionnaire (SHIM)Score for Erectile Dysfunction1-7: Severe8-11: Moderate12-16: Mild-moderate17-21: Mild22-25: No Erectile Dysfunction

Welcome to the International Index of Erectile Function (IIEF) Questionnaire

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

The IIEF-5 Questionnaire (SHIM)

Score for Erectile Dysfunction

1-7: Severe
8-11: Moderate
12-16: Mild-moderate
17-21: Mild
22-25: No Erectile Dysfunction