Your individual results are not stored or shared with anyone.
Share the results with your doctor. Your doctor can recommend an effective treatment, like VIAGRA. To get your results:
- Print this page
- Circle the answers that best describe you
- Then add your scores to see if your symptoms of ED are mild, moderate, or severe
- How do you rate your confidence that you could get and keep an erection?
- (1) Very low
- (2) Low
- (3) Moderate
- (4) High
- (5) Very high
- When you had erections with sexual stimulation, how often were your erections hard
enough for penetration (entering 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
- During sexual intercourse, how often were you able to maintain your erection after
you had penetrated (entered) your partner?
- (0) Did not attempt intercourse
- (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
- 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
- When you attempted sexual intercourse, how often was it satisfactory for you?
- (0) Did not attempt intercourse
- (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
Add up your scores to get your total
The chart below will tell you if you have signs of ED. And whether it is mild, moderate,or
severe.

Remember to talk to your doctor about your results. It’s a great way to get the conversation started.
Share the results with your doctor. Your doctor can recommend an effective treatment, like VIAGRA. To get your results:
- Print this page
- Circle the answers that best describe you
- Then add your scores to see if your symptoms of ED are mild, moderate, or severe
- How do you rate your confidence that you could get and keep an erection?
- (1) Very low
- (2) Low
- (3) Moderate
- (4) High
- (5) Very high
- When you had erections with sexual stimulation, how often were your erections hard
enough for penetration (entering 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
- During sexual intercourse, how often were you able to maintain your erection after
you had penetrated (entered) your partner?
- (0) Did not attempt intercourse
- (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
- 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
- When you attempted sexual intercourse, how often was it satisfactory for you?
- (0) Did not attempt intercourse
- (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
Add up your scores to get your total
The chart below will tell you if you have signs of ED. And whether it is mild, moderate,or
severe.

Remember to talk to your doctor about your results. It’s a great way to get the conversation started.
