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IIEF Patient Questionnaire | Clinical Assessment

    International Index of Erectile Function (IIEF)

    Clinical Assessment Questionnaire

    These questions ask about the effects that your erection problems have had on your sex life over the last four weeks. Please try to answer the questions as honestly and as clearly as you are able.

    Definitions:
    • Sexual activity: Includes intercourse, caressing, foreplay & masturbation.
    • Sexual intercourse: includes situation such as foreplay, erotic pictures etc.
    • Sexual stimulation: Fulfilment or climax following stimulation.
    • Ejaculation: Is the ejection of semen from the penis (or the feeling of this)
    • Orgasm: Is the fulfilment or climax following sexual stimulation or intercourse
    OVER THE PAST 4 WEEKS — CHECK ONE BOX ONLY
    1. How often were you able to get an erection during sexual activity?
    0 - No sexual activity1 - Almost never or never2 - A few times (less than half the time)3 - Sometimes (about half the time)4 - Most times (more than half the time)5 - Almost always or always
    2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration?
    0 - No sexual activity1 - Almost never or never2 - A few times (less than half the time)3 - Sometimes (about half the time)4 - Most times (more than half the time)5 - Almost always or always
    3. When you attempted intercourse, how often were you able to penetrate (enter) your partner?
    0 - Did not attempt intercourse1 - Almost never or never2 - A few times (less than half the time)3 - Sometimes (about half the time)4 - Most times (more than half the time)5 - Almost always or always
    4. During sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner?
    0 - Did not attempt1 - Almost never2 - A few times3 - Sometimes4 - Most times5 - Almost always
    5. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
    0 - Did not attempt1 - Extremely difficult2 - Very difficult3 - Difficult4 - Slightly difficult5 - Not difficult
    6. How many times have you attempted sexual intercourse?
    0 - No attempts1 - 1-2 attempts2 - 3-4 attempts3 - 5-6 attempts4 - 7-10 attempts5 - 11+ attempts
    7. When you attempted sexual intercourse, how often was it satisfactory for you?
    0 - Did not attempt1 - Almost never2 - A few times3 - Sometimes4 - Most times5 - Almost always
    8. How much have you enjoyed sexual intercourse?
    0 - No intercourse1 - No enjoyment2 - Not very enjoyable3 - Fairly enjoyable4 - Highly enjoyable5 - Very highly enjoyable
    9. When you had sexual stimulation or intercourse, how often did you ejaculate?
    0 - No stimulation1 - Almost never2 - A few times3 - Sometimes4 - Most times5 - Almost always
    10. When you had sexual stimulation or intercourse, how often did you have the feeling of orgasm or climax?
    0 - No stimulation1 - Almost never2 - A few times3 - Sometimes4 - Most times5 - Almost always
    11. How often have you felt sexual desire?
    1 - Almost never2 - A few times3 - Sometimes4 - Most times5 - Almost always
    12. How would you rate your level of sexual desire?
    1 - Very low / none2 - Low3 - Moderate4 - High5 - Very high
    13. How satisfied have you been with your overall sex life?
    1 - Very dissatisfied2 - Moderately dissatisfied3 - Equally satisfied / dissatisfied4 - Moderately satisfied5 - Very satisfied
    14. How satisfied have you been with your sexual relationship with your partner?
    1 - Very dissatisfied2 - Moderately dissatisfied3 - Equally satisfied / dissatisfied4 - Moderately satisfied5 - Very satisfied
    15. How do you rate your confidence that you could get and keep an erection?
    1 - Very low2 - Low3 - Moderate4 - High5 - Very high
    Free ED Consultation

    What Should You Do After Completing the IIEF Test?

    If your score suggests erectile dysfunction, the next step is a clinical assessment. At Marylebone Diagnostic Centre we may recommend:

    ● Shockwave therapy
    ● Hormone blood testing
    ● Circulation health checks
    ● Lifestyle optimisation
    Maintenance Care

    Already Had Shockwave Therapy Before?

    If you previously completed shockwave therapy and would like to maintain your results, top-up treatments may help.

    At Marylebone Diagnostic Centre we also support patients who:

    ✓ Had treatment elsewhere
    ✓ Want a second opinion
    ✓ Need maintenance or booster sessions
    Clinical Pathway

    What Should You Do After Completing the IIEF Test?

    If your score suggests erectile dysfunction, the next step is a clinical assessment. At Marylebone Diagnostic Centre we may recommend:

    • Shockwave therapy
    • Hormone blood testing
    • Circulation health checks
    • Lifestyle optimisation

    Marylebone Diagnostic Centre offers shockwave therapy for erectile dysfunction in Central London, just a few minutes from Baker Street station.

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