Sexual Health Questionnaire

Question 0 1 2 3 4 5
How do you rate your confidence that you could get an erection? Very Low

1

Low

2

Moderate

3

High

4

Very High

5

When you had erections with sexual stimulation, how often were your erections hard enough for penetration? No Sexual Activity

0

Almost Never/Never

1

A few times

2

Sometimes

3

Most Times

4

Almost Always/Always

5

During sexual intercourse, how often were you able to maintain your erection intercourse after you had penetrated (entered) your partner? Did not attempt

0

Almost Never/Never

1

A few times

2

Sometimes

3

Most times

4

Almost Always/Always

5

During sexual intercourse, how difficult was it to maintain your erection to intercourse completion of intercourse? Did not attempt

0

Extremely difficult

1

Very difficult

2

Difficult

3

Slightly attempt

4

Not attempt

5

When you attempted sexual intercourse, how often was it satisfactory to you? Did not attempt

0

Almost Never/Never

1

A few times

2

Sometimes

3

Most Times

4

Almost Always/Always

5