Sexual health. Questionnaire for men

1. How do you assess the confidence that you can achieve an erection and maintain it?

Very low – 1
Low – 2
Average – 3
High – 4
Very high – 5

2. When you had an erection with sexual stimulation, how often were you able to insert the penis into the vagina?

No sexual activity – 0
Almost never or never – 1
Occasionally (much less often than in half of the cases) – 2
Sometimes (about half of the time) – 3
Often (much more often than half of the time) – 4
Almost always or always – 5

3. During sexual intercourse, how often did you manage to maintain an erection after penetration of the penis into the vagina?

Did not try to perform sexual intercourse – 0
Almost never or never – 1
Occasionally (much less often than in half of the cases) – 2
Sometimes (about half of the time) – 3
Often (much more often than half of the time) – 4
Almost always or always – 5

4. How difficult was it for you to maintain an erection until the end of sexual intercourse?

Did not try to perform sexual intercourse – 0
Extremely difficult – 1
Very difficult – 2
Difficult – 3
Not very difficult – 4
Not difficult – 5

5. When you tried to have sexual intercourse, how often did you find the result satisfactory?

Did not try to perform sexual intercourse – 0
Almost never or never – 1
Occasionally (much less often than in half of the cases) – 2
Sometimes (about half of the time) – 3
Often (much more often than half of the time) – 4
Almost always or always – 5

Count the number of points.

1-7 – high degree of erectile dysfunction;
8-11 – moderate erectile dysfunction;
12-16 – mild to moderate erectile dysfunction;
17-21 – mild erectile dysfunction.


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