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2020-03-07T12:18:10+00:00
Important:
Be honest with your answer and select the answer that most closely applies to you on average over the last
6 months
1. How do you rate your
confidence
that you could get and keep an erection?
Very Low
Low
Moderate
High
Very High
Important:
Be honest with your answer and select the answer that most closely applies to you on average over the last
6 months
2. When you had erections with sexual stimulation,
how often
were your erections hard enough for penetration?
Almost never/never
A few times (much less than half the time)
Sometimes (about half the time)
Most times (much more than half the time)
Almost always/always
Important:
Be honest with your answer and select the answer that most closely applies to you on average over the last
6 months
3. During sexual intercourse,
how often
were you able to maintain your erection after you had penetrated (entered) your partner?
Almost never/never
A few times (much less than half the time)
Sometimes (about half the time)
Most times (much more than half the time
Almost always/always
Important:
Be honest with your answer and select the answer that most closely applies to you on average over the last
6 months
4. During sexual intercourse,
how difficult
was it to maintain your erection to completion of intercourse?
Extremely difficult
Very difficult
Difficult
Slightly difficult
Not difficult
Important:
Be honest with your answer and select the answer that most closely applies to you on average over the last
6 months
5. When you attempted sexual intercourse,
how often
was it satisfactory for you?
Almost never/never
A few times (much less than half the time)
Sometimes (about half the time)
Most times (much more than half the time)
Almost always/always
6 out of 5
Time is Up!