Erectile dysfunction (ED) is the male inability during sexual stimulation, to get and keep an erection hard enough for penetration, maintenance, and completion of sexual intercourse, resulting in a lack of satisfaction for the male.
Shim Clinic has a special focus on the diagnosis and treatment of erectile dysfunction.
Physical causes of ED result from vascular and neurological damage caused by diabetes and hypertension, and also hormonal insufficiencies. Psychological causes also play a part like lack of interest in the partner.
Penile erection results when the sponge-like body is engorged when blood that enters it is prevented from exiting. Stimulus from the brain travelling through nerves that enter the penis trigger this activity, and results from sexual arousal.
Erectile dysfunction may be assessed with the international index of erectile function (IIEF-5) a.k.a. sexual health inventory for men (SHIM), and an erectile dysfunction diagnosis made:
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||Low||Moderate||High||Very high|
|2||When you had erections with sexual stimulation, how often were your erections hard enough for penetration?||Almost never / never||A few times (much less than half the time)||Sometimes (about half the time)||Most times (much more than half the time)||Almost always / always|
|3||During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?||Almost never / never||A few times (much less than half the time)||Sometimes (about half the time)||Most times (much more than half the time)||Almost always / always|
|4||During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?||Extremely difficult||Very difficult||Difficult||Slightly difficult||Not difficult|
|5||When you attempted sexual intercourse, how often was it satisfactory for you?||Almost never / never||A few times (much less than half the time)||Sometimes (about half the time)||Most times (much more than half the time)||Almost always / always|
aThe IIEF-5 score is the sum of the ordinal responses to the five items; thus, the score can range from 5 to 25.
- severe (5-7),
- moderate (8-11),
- mild to moderate (12-16),
- mild (17-21), and
- no ED (22-25).
- R C Rosen, J C Cappelleri, M D Smith, J Lipsky and B M Peña
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 Dec;11(6):319-26.
- IIEF-5 in Japanese