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IIEF-5 erectile function test.
The standard five-question questionnaire used worldwide to measure erectile dysfunction. Your answers are scored on your own device only.
What is the IIEF-5 test?
The IIEF-5 is the short version of the 15-item International Index of Erectile Function (IIEF), developed by Rosen and colleagues in 1999; it is also known as the SHIM (Sexual Health Inventory for Men). Its five questions ask about your erections and sexual intercourse over the past six months. The higher the total, the better the erectile function; in the development study a score of 21 or below was taken to indicate erectile dysfunction (ED).
Urologists use the test both at the first assessment and to follow the effect of treatment. Because it is short and standardised, you can complete it before your appointment and bring the result with you.
How do I fill in the test?
Answer each question thinking about the past six months and choose the one option that best reflects your situation. Question 1 is scored 1–5 and the other four questions 0–5. In the original questionnaire the options “No sexual activity” and “Did not attempt intercourse” score 0; choosing them lowers the total even without an erection problem. Your score updates on screen as you answer.
How is the IIEF-5 score interpreted?
The test is a screening and severity scale; it does not make a diagnosis or show the cause. Stress, tiredness, relationship issues, some medicines, alcohol and smoking can all affect the result. A definitive assessment is based on your history, a physical examination and, where needed, tests.
| Your IIEF-5 score | Score ranges |
|---|---|
| 22–25 | No signs of erectile dysfunction |
| 17–21 | Mild erectile dysfunction |
| 12–16 | Mild to moderate erectile dysfunction |
| 8–11 | Moderate erectile dysfunction |
| 5–7 | Severe erectile dysfunction |
Why should erection problems be taken seriously?
The arteries of the penis are narrower than those of the heart, so hardening of the arteries sometimes shows up first as an erection problem. The European Association of Urology (EAU) guidelines point out that erectile dysfunction shares risk factors with cardiovascular disease and can be an early sign of it. Diabetes, high blood pressure, high cholesterol, smoking, excess weight and lack of exercise are the main risk factors.
When should I see a urologist?
A urological assessment is recommended if any of the following applies to you:
- Your score is 21 or below and this bothers you or your partner
- The problem started suddenly or is getting worse
- You have diabetes, heart disease or high blood pressure, or take regular medication
- You also have reduced sex drive, a curved penis or pain
- You have had prostate or pelvic surgery or radiotherapy
What happens at the assessment and treatment?
Your history is taken and you are examined; blood tests such as glucose, cholesterol and testosterone may be requested. Treatment is planned according to the cause: lifestyle changes, PDE5 inhibitor tablets (e.g. sildenafil, tadalafil), medicines applied to the penis and vacuum devices may be considered. When these are not effective or not suitable, a penile implant is an option.
Frequently asked questions about the IIEF-5
My IIEF-5 score is below 21. Does that mean I definitely have erectile dysfunction?
The test alone does not make a diagnosis. A score of 21 or below indicates the likelihood and severity of an erection problem. Temporary stress, tiredness or relationship factors can also lower the score. If your score is low and it bothers you, seeing a urologist to assess the cause is recommended.
Can I take the test if I have not had sex in the past 6 months?
You can, but the answers “No sexual activity” or “Did not attempt intercourse” score 0 and lower the total even without an erection problem. The result may therefore not fully reflect your situation; simply mention this to your doctor.
Can erectile dysfunction be a sign of heart disease?
It can. Erectile dysfunction and cardiovascular disease share risk factors such as hardening of the arteries, diabetes, high blood pressure and smoking, and ED sometimes appears before these conditions. A cardiovascular risk assessment is therefore recommended, especially when erection problems are new. If you have chest pain or shortness of breath, see a doctor without delay.
How often should I repeat the test?
Because the test asks about the past six months, repeating it at short intervals is not meaningful. If you have started treatment, filling it in again at the follow-up visits your doctor recommends helps track change.
Are my answers stored anywhere?
No. The score is calculated in your browser only; your answers are not sent to any server and are cleared when you close the page.
Sources
- Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11(6):319–326. doi.org/10.1038/sj.ijir.3900472
- European Association of Urology (EAU). Guidelines on Sexual and Reproductive Health – Erectile dysfunction. uroweb.org/guidelines/sexual-and-reproductive-health
- Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA Guideline. J Urol. 2018;200(3):633–641. doi.org/10.1016/j.juro.2018.05.004
- Utomo E, Blok BF, Pastoor H, Bangma CH, Korfage IJ. The measurement properties of the five-item International Index of Erectile Function (IIEF-5): a Dutch validation study. Andrology. 2015;3(6):1154–1159. doi.org/10.1111/andr.12112
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