The Erection Hardness Score (EHS) is much less sophisticated than you might imagine. Subjects are merely asked to assess their level of hardness based on the following:
EHS 1 = Penis is larger but not hard
EHS 2 = Penis is hard, but not hard enough for penetration
EHS 3 = Penis is hard enough for penetration but not completely hard
EHS 4 = Penis is completely hard and fully rigid
Interpretation:
EHS 1 = no ED
EHS 2 = mild ED
EHS 3 = moderate ED
EHS 4 = severe ED
The "gold standard" for assessment of erectile dysfunction is also a questionnaire: the 15-question International Index of Erectile Function (IIEF). The IIEF is as follows (all questions relate to activities over the last 4 weeks):
1. How often were you able to get an erection during sexual activity? no sexual activity=0, never or almost never=1, a few times=2, sometimes =3, most times=4, almost always or always=5
2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration? no sexual activity=0, never or almost never=1, a few times=2, sometimes=3, most times=4, almost always or always=5
3. When you attempted sexual intercourse, how often were you able to penetrate (enter) your partner? did not attempt=0, never or almost never=1, a few times=2, sometimes=3, most times=4, almost always or always=5
4. During sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner? did not attempt=0, never or almost never=1, a few times=2, sometimes=3, most times=4, almost always or always=5
5. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse? did not attempt=0, extremely difficult=1, very difficult=2, difficult=3, slightly difficult=4, not difficult=5
6. How many times have you attempted sexual intercourse? no attempts=0, 1-2 attempts=1, 3-4 attempts=2, 5-6 attempts=3, 7-10 attempts=4, >= 11 attempts=5
7. When you attempted sexual intercourse, how often was it satisfactory for you? did not attempt=0, never or almost never=1, a few times=2, sometimes=3, most times=4, almost always or always=5
8. How much have you enjoyed sexual intercourse? no intercourse=0, no enjoyment=1, not very enjoyable=2, fairly enjoyable=3, highly enjoyable=4, very highly enjoyable=5
9. When you had sexual simulation or intercourse, how often did you ejaculate? no sexual activity=0, never or almost never=1, a few times=2, sometimes=3, most times=4, almost always or always=5
10. When you had sexual stimulation or intercourse, how often did you have the feeling of orgasm or climax? no sexual activity=0, never or almost never=1, a few times=2, sometimes=3, most times=4, almost always or always=5
11. How often have you felt sexual desire? never or almost never=1, a few times=2, sometimes=3, most times=4, almost always=5
12. How would you rate your level of sexual desire? very low or none=1, low=2, moderate=3, high=4, very high=5
13. How satisfied have you been with your overall sex life? very dissatisfied=1, moderately dissatisfied=2, about equal=3, moderately satisfied=4, very satisfied=5
14. How satisfied have you been with your sexual relationship with your partner? very dissatisfied=1, moderately dissatisfied=2, about equal=3, moderately satisfied=4, very satisfied=5
15. How do you rate your confidence that you could get an keep an erection? very low=1, low=2, moderate=3, high=4, very high=5
Scoring:
subscore for erectile function = SUM(points for questions 1, 2, 3, 4, 5, 15). Maximum is 30.
subscore for orgasmic function = SUM(points for questions 9 and 10). Maximum is 10
subscore for sexual desire = SUM(points for questions 11 and 12). Maximum is 10
subscore for intercourse satisfaction = SUM(points for questions 6, 7, 8). Maximum is 15
subscore for overall satisfaction = SUM(points for questions 13 and 14). Maximum is 10
overall score = SUM(points for all 15 questions). Maximum is 75.
Interpretation:
IIEF score more than 25 = no ED
IIEF score 17-25 = mild ED
IIEF score 11-16 = moderate ED
IIEF score less than 11 = severe ED
