• Sexual Health Inventory for Men

  • Sexual health is an important part of an individual’s overall physical and emotional well-being. Erectile dysfunction, also known as impotence, is one type of a very common medical condition affecting sexual health. Fortunately, there are many different treatment options for erectile dysfunction. This questionnaire is designed to help you and your doctor identify if you may be experiencing erectile dysfunction. If you are, you may choose to discuss treatment options with your doctor.

  • Date*
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  • Birthday*
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  • How do you rate your confidence that you could get and keep an erection?*
  • When you had erections with sexual stimulation, how often were your erections hard enough for penetration (entering your partner)?*
  • During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?*
  • During sexual intercourse,how difficult is it to maintain your erection to completion of intercourse?*
  • When you attempted sexual intercourse, how often was it satisfactory for you?*

  • If your total score is 21 or less, you may want to speak to your doctor. Please print and bring your assessment to your appointment.

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