Online ED Assessment
INTERNATIONAL INDEX OF ERECTILE FUNCTION (IIEF)
Guidelines on Clinical Application of IIEF Patient Questionnaire
Background
The 15-question International Index of Erectile Function (IIEF) Questionnaire is a validated, multi-dimensional, self-administered investigation that has been found useful in the clinical assessment of erectile dysfunction and treatment outcomes in clinical trials. A score of 0-5 is awarded to each of the 15 questions that examine the 4 main domains of male sexual function: erectile function, orgasmic function, sexual desire and intercourse satisfaction.
In a recent study (1) ,the IIEF Questionnaire was tested in a series of 111 men with sexual dysfunction and 109 age-matched, normal volunteers. The following mean scores were recorded:
| FUNCTION DOMAIN | MAX SCORE | CONTROLS | PATIENTS |
|---|---|---|---|
|
A. Erectile Function (Q1,2,3,4,5,15) |
30 |
25.8 |
10.7 |
|
B. Orgasmic Function (Q9,10) |
10 |
9.8 |
5.3 |
|
C. Sexual Desire (Q11,12) |
10 |
7.0 |
6.3 |
|
D. Intercourse Satisfaction (Q6,7,8) |
15 |
10.6 |
5.5 |
|
E. Overall Satisfaction (Q13,14) |
10 |
8.6 |
4.4 |
Clinical Application
IIEF assessment is limited by the superficial assessment of psychosexual background and the very limited assessment of partner relationship, both important factors in the presentation of male sexual dysfunction. Analysis of the questionnaire should, therefore, be viewed as an adjunct to, rather than a substitute for, a detailed sexual history and examination. The following guide-lines may be applied:
- Patients with low IEEF scores (<14 out of 30) in Domain A (Erectile Function) may be considered for a trial course of therapy with Sildenafil unless contraindicated. Specialist referral is indicated if this is unsuccessful.
- Patients demonstrating primary orgasmic or ejaculatory dysfunction (Domain B) should be referred for specialist investigation.
- Patients with reduced sexual desire (Domain C) require testing of blood levels of androgen and prolactin.
- Psychosexual counselling should be considered if low scores are recorded in Domains D and E but there is only a moderately lowered score (14 to 25) in Domain A.
Reference
1. Rosen R, Riley A, Wagner G, et al. The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 1997, 49: 822-830.