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IIEF Questionnaire

IIEF: International Index of Erectile Function Questionnaire

Investigator: ______________________________________

Date of Visit:______________________________________

  

Please use an X where applicable and be sure to initial and date all corrections

Score 0 if not done_______________ Subject questionnaire Section 1

Instructions: These questions ask about the effects your erection problems have had on your sex life, over the past 4 weeks. Please answer the following questions as honestly and clearly as possible. In answering these questions, the following definitions apply:

Definitions:

Sexual activity includes intercourse, caressing, foreplay and masturbation

Sexual intercourse is defined as vaginal penetration of the partner (you entered the partner)

Sexual stimulation includes situations like foreplay with a partner, looking at erotic pictures, etc.

Ejaculate is defined as the ejection of semen from the penis (or the feeling of this)

Mark ONLY one circle per question:

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

0 No sexual activity
0 Almost always or always
0 Most times (much more than half the time)
0 Sometimes (about half the time)
0 A few times (much less than half the time)
0 Almost never or never

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

0 No sexual stimulation
0 Almost always or always
0 Most times (much more than half the time)
0 Sometimes (about half the time)
0 A few times (much less than half the time)
0 Almost never or never

Questions 3, 4 and 5 will ask about erections you may have had during sexual intercourse.

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

0 Did not attempt intercourse
0 Almost always or always
0 Most times (much more than half the time)
0 Sometimes (about half the time)
0 A few times (much less than half the time)
0 Almost never or never

4. 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 Did not attempt intercourse
0 Almost always or always
0 Most times (much more than half the time)
0 Sometimes (about half the time)
0 A few times (much less than half the time)
0 Almost never or never

5. 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
0 Almost always or always
0 Most times (much more than half the time)
0 Sometimes (about half the time) 0 A few times (much less than half the time)
0 Almost never or never

6. Over the past 4 weeks, how many times have you attempted sexual intercourse?

0 No attempts
0 1-2 attempts
0 3-4 attempts
0 5-6 attempts
0 7-10 attempts
0 11 or more attempts

7. Over the past 4 weeks, when you attempted sexual intercourse how often was it satisfactory for you?

0 Did not attempt intercourse
0 Almost always or always
0 Most times (much more than half the time)
0 Sometimes (about half the time)
0 A few times (much less than half the time)
0 Almost never or never

8. Over the past 4 weeks, how much have you enjoyed sexual intercourse?

0 No intercourse
0 Very highly enjoyable
0 Highly enjoyable
0 Fairly enjoyable
0 Not very enjoyable
0 Not enjoyable

9. Over the past 4 weeks, when you had sexual stimulation or intercourse how often did you ejaculate?

0 Did not attempt intercourse
0 Almost always or always
0 Most times (more than half the time)
0 Sometimes (about half the time)
0 A few times (much less than half the time)
0 Almost never or never

10. Over the past 4 weeks, when you had sexual stimulation or intercourse how often did you have the feeling of orgasm or climax (with or without ejaculation)?

0 No sexual stimulation or intercourse
0 Almost always or always
0 Most times (much more than half the time)
0 Sometimes (about half the time)
0 A few times (much less than half the time)
0 Almost never or never

Questions 11 and 12 ask about sexual desire. Let's define sexual desire as a feeling that may include wanting to have a sexual experience (for example, masturbation or intercourse), thinking about having sex or feeling frustrated due to a lack of sex.

11. Over the past 4 weeks, how often have you felt sexual desire?

0 Almost always or always
0 Most times (much more than half the time)
0 Sometimes (about half the time)
0 A few times (much less than half the time)
0 Almost never or never

12. Over the past 4 weeks, how would you rate your level of sexual desire?

0 Very high
0 High
0 Moderate
0 Low
0 Very low or none at all

13. Over the past 4 weeks, how satisfied have you been with you overall sex life?

0 Very satisfied
0 Moderately satisfied
0 About equally satisfied and dissatisfied
0 Moderately dissatisfied
0 Very dissatisfied

14. Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner?

0 Very satisfied
0 Moderately satisfied
0 About equally satisfied and dissatisfied
0 Moderately dissatisfied
0 Very dissatisfied

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

0 Very high
0 High
0 Moderate
0 Low
0 Very low


Scoring Algorithm for IIEF

All items are scored in 5 domains as follows:

Domain
Items
Range
Score Max
Score
Erectile Function 1, 2, 3, 4, 5, 15  0-5 30
Orgasmic Function 9, 10  0-5 10
Sexual Desire 11, 12  0-5 10
Intercourse Satisfaction 6, 7, 8  0-5 15
Overall Satisfaction 13, 14  0-5 10

Clinical Interpretation

I. Erectile function total scores can be interpreted as follows:

Score Interpretation
0-6 Severe dysfunction
   
7-12 Moderate dysfunction
   
13-18 Mild to moderate dysfunction
   
19-24 Mild dysfunction
   
25-30 No dysfunction
   

II. Orgasmic function total scores can be interpreted as follows:

Score Interpretation
0-2 Severe dysfunction
   
3-4 Moderate dysfunction
   
5-6 Mild to moderate dysfunction
   
7-8 Mild dysfunction
   
9-10 No dysfunction
   

III. Sexual desire total scores can be interpreted as follows:

Score Interpretation
0-2 Severe dysfunction
   
3-4 Moderate dysfunction
   
5-6 Mild to moderate dysfunction
   
7-8 Mild dysfunction
   
9-10 No dysfunction
   

IV. Intercourse satisfaction total scores can be interpreted as follows:

Score Interpretation
0-3 Severe dysfunction
   
4-6 Moderate dysfunction
   
7-9

Mild to moderate dysfunction

   
10-12 Mild dysfunction
   
13-15 No dysfunction
   

V. Overall satisfaction total scores can be interpreted as follows:

Score Interpretation
0-2 Severe dysfunction
   
3-4 Moderate dysfunction
   
5-6 Mild to moderate dysfunction
   
7-8 Mild dysfunction
   
9-10 No dysfunction
   

Source: Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A.
The international index of erectile function (IIEF) a multidimensional scale for assessment of erectile dysfunction. Urology. 1997 Jun; 49(6):822-30. Copyright 1997 by Elsevier Science, Inc.

References: See Bibliography

August 2006
Posted March 2013

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