Dr Alain Bitton: Urolog and Androlog

IIEF Questionnaire (International Index of Erectile Function )

Instructions: these questions regard the effects that your erection problems have had on your sexual life during the past 4 weeks. Please, answer the following questions as honestly and clearly as you can. Use the following definitions to answer these questions:

sexual activity: sexual relationship, caresses, petting, masturbation
intercourse: vaginal penetration of the partner (you penetrated your partner)
sexual stimulation: situations like petting with a partner, watching erotic images, etc...
ejaculation: ejection (or feeling of ejection) of sperm out of the penis

Mark ONLY ONE case per question!

Questionnaire

Over the past 4 weeks, how often were you able to get an erection during sexual activity?

	0 - No sexual activity
	1 - Almost never or 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 or always

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Over the past 4 weeks, when you had erections with sexual stimulation, how often were your erections hard enough for penetration?

	0 - No sexual activity
	1 - Almost never or 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 or always

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

The 3 following questions will ask about erections you may have had during sexual intercourse.

Over the past 4 weeks, when you attempted sexual intercourse, how often were you able to penetrate (enter) your partner?

	0 - No sexual activity
	1 - Almost never or 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 or always

Over the past 4 weeks, during sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?

	0 - Aucune activité sexuelle
	1 - Pratiquement jamais ou jamais
	2 - Quelques fois (beaucoup moins que la moitié du temps)
	3 - Parfois (environ la moitié du temps)
	4 - La plupart du temps (beaucoup plus que la moitié du temps)
	5 - Pratiquement toujours ou toujours

Over the past 4 weeks, 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

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Over the past 4 weeks, how do you rate your confidence that you can get and keep your erection?

	0 – Very low
	1 – Low
	2 - Moderate
	3 - High
	4 – Very high

Your total IIEF score (0 to 29) is:

References: Rosen RC, Riley A, Wagner G et al.: The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49 (6):822-830

Severity of ED according to IIEF

Total of 6 items

1 - 10 .......... Severe dysfunction
11 - 16 ........ Moderate dysfunction
17 - 25 ........ Mild dysfunction
26 - 29 ........ Normal (no ED)

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Last updates: January 2017