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Erectile Dysfunction (ED)
Premature Ejaculation (PE)
Androgen Deficiency (AD)
Answer the following 3 questionnaires and submit:

Table 2  The IIEF-5 questionnairea

Over the past six months:

  1. How do you rate your confidence that you could get and keep an erection?
    Very low 1
    Low 2
    Moderate 3
    High 4
    Very high 5
  2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration?
    Almost never / never 1
    A few times (much less than half the time) 2
    Sometimes (about half the time) 3
    Most times (much more than half the time) 4
    Almost always / always 5
  3. During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?
    Almost never / never 1
    A few times (much less than half the time) 2
    Sometimes (about half the time) 3
    Most times (much more than half the time) 4
    Almost always / always 5
  4. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
    Extremely difficult 1
    Very difficult 2
    Difficult 3
    Slightly difficult 4
    Not difficult 5
  5. When you attempted sexual intercourse, how often was it satisfactory for you?
    Almost never / never 1
    A few times (much less than half the time) 2
    Sometimes (about half the time) 3
    Most times (much more than half the time) 4
    Almost always / always 5
aThe IIEF-5 score is the sum of the ordinal responses to the five items; thus, the score can range from 5 to 25.

ED severity:
  • severe (5-7),
  • moderate (8-11),
  • mild to moderate (12-16),
  • mild (17-21), and
  • no ED (22-25).

Appendix B. Final PE Diagnostic Tool

Tool for Assessing Premature Ejaculation

This is a questionnaire to help identify men who may have a problem with ejaculating too soon during sexual activity. Even if you do not have difficulties, please answer all the questions.
  • Please mark the box that best represents your answer for each of the questions below.
  • Please mark only one box for each question.
  • Remember there are no right or wrong answers to these questions.
  • While your experiences may change from time to time, what we're interested in here is your general experience with intercourse.
Definition:
Ejaculation here refers to ejaculation (release of semen) after penetration (when your penis enters your partner)

  1. How difficult is it for you to delay ejaculation?
    Not difficult at all 0
    Somewhat difficult 1
    Moderately difficult 2
    Very difficult 3
    Extremely difficult 4
  2. Do you ejaculate before you want to?
    Almost never or never 0% 0
    Less than half the time 25% 1
    About half the time 50% 2
    More than half the time 75% 3
    Almost always or always 100% 4
  3. Do you ejaculate with very little stimulation?
    Almost never or never 0% 0
    Less than half the time 25% 1
    About half the time 50% 2
    More than half the time 75% 3
    Almost always or always 100% 4
  4. Do you feel frustrated because of ejaculating before you want to?
    Not at all 0
    Slightly 1
    Moderately 2
    Very 3
    Extremely 4
  5. How concerned are you that your time to ejaculation leaves your partner sexually unfulfilled?
    Not at all 0
    Slightly 1
    Moderately 2
    Very 3
    Extremely 4
Pfizer Ltd ©: 27 July 2005

Score:
  • ≤8 "no PE,"
  • 9 and 10 "probable PE," and
  • ≥11 "PE."

Table 1. Questions Used as Part of the Saint Louis University ADAM Questionnaire
  1. Do you have a decrease in libido (sex drive)?
    Yes | No
  2. Do you have a lack of energy?
    Yes | No
  3. Do you have a decrease in strength and/or endurance?
    Yes | No
  4. Have you lost height?
    Yes | No
  5. Have you noticed a decreased "enjoyment of life"?
    Yes | No
  6. Are you sad and/or grumpy?
    Yes | No
  7. Are your erections less strong?
    Yes | No
  8. Have you noted a recent deterioration in your ability to play sports?
    Yes | No
  9. Are you falling asleep after dinner?
    Yes | No
  10. Has there been a recent deterioration in your work performance?
    Yes | No
NOTE. A positive questionnaire result is defined as a "yes" answer to questions 1 or 7 or any 3 other questions.

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