ED Assessment in 5 Minutes

Which best describes your situation?
- I have erectile dysfunction.
- My partner has erectile dysfunction.
How long have you or your partner suffered from erectile dysfunction?
- 0 - 6 months
- 6 months - 2 years
- 2 - 5 years
- More than 5 years
Rate your confidence that you or your partner can get and keep an erection.
- Very low
- Low
- Moderate
- High
- Very High
When you or your partner have had erections with sexual stimulation, how often have the erections been hard enough for penetration (entering partner)?
- No sexual activity
- Almost never or never
- A few times (less than half the time)
- Sometimes (about half the time)
- Most times (more than half the time)
- Almost always or always
During sexual intercourse, how often have you or your partner been able to maintain an erection after penetration (entering of partner)?
- No longer attempting intercourse
- Almost never or never
- A few times (less than half the time)
- Sometimes (about half the time)
- Most times (more than half the time)
- Almost always or always
During sexual intercourse, how difficult has it been for you or your partner to maintain your erection to completion of intercourse?
- Did not attempt intercourse
- Extremely difficult
- Very difficult
- Difficult
- Slightly difficult
- Not difficult
When attempting sexual intercourse, how often has it been satisfactory for you?
- No longer attempting intercourse
- Almost never or never
- A few times (less than half the time)
- Sometimes (about half the time)
- Most times (more than half the time)
- Almost always or always
Select all treatments you have tried.
- Pills
- Vacuum
- Injections
- Suppositories
- None
Have you been diagnosed with any of the following medical conditions which may be related to ED?
- Diabetes
- Prostate Cancer
- Heart Disease
- None
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