The International Index of Erectile Function questionnaire is a fairly accurate tool for the diagnosis of erectile dysfunction, but as presently constituted it offers little indication of the specific cause of impotence.
Even a casual follower of medical research into erectile dysfunction, its causes, and possible treatments can’t miss seeing references to IIEF, a widely used gauge of male sexual function.
Short for International Index of Erectile Function, IIEF is a self-administered set of 15 questions designed to help assess a man’s ability to get and keep an erection suitable for intercourse. Also available in a shortened five-question format (IIEF-5), the questionnaire is routinely given to study participants before and after clinical testing of experimental ED treatments.
Other Aspects of Sexual Function
The full 15-question IIEF attempts to gauge not just the subject’s erectile function but other aspects of the sexual experience as well. These include orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. The five-question IIEF-5 focuses solely on erectile function.
The lower a man’s score on the IIEF questionnaire, the more likely he is to be suffering from some degree of ED. On the IIEF-5, each of the five questions has five possible responses, ranging in value from 1 to 5.
A Sample IIEF-5 Question
As an example, the first of the IIEF-5’s questions is “How do you rate your confidence that you could get and keep an erection?” Possible responses are Very Low, worth 1; Low, worth 2; Moderate, worth 3; High, worth 4; and Very High, worth 5.
Toting up a patient’s score based on his responses to the five questions on the IIEF-5 questionnaire, a score of 1-7 is indicative of severe ED; 8-11 points to moderate ED; 12-16 suggests mild to moderate ED; 17-21 indicates mild ED; and 22-25 is indicative of no ED.
While both forms of the IIEF questionnaire have been found to offer accurate assessments of a man’s erectile function, neither questionnaire is found to offer any real insight into what condition is causing the unsatisfactory erectile performance.
Findings of Chinese Study
In a study published in the July 2014 issue of BMC Urology, a team of Chinese researchers looked at IIEF-5 scores of 3,327 impotent men whose ED stemmed from various causes, both physiological and psychological.
While men with ED of psychological origin scored somewhat higher than men with ED of a physiological nature, researchers found no significant differences in scores between men of differing organic pathophysiologies. They concluded that, based on their data, “IIEF-5 is not a definitive diagnostic tool to discriminate the pathophysiological causes of ED.”
Findings of Slovenian Study
Similar conclusions were reached by a team of Slovenian researchers who published their findings in the July 2018 issue of The Journal of Sexual Medicine. They suggested that future IIEF testing take into account such other defining factors as lifestyle, socioeconomic status, and existing comorbidities. For subjects with ED of a psychosexual nature, this additional information would help steer them to the proper form of therapy.
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