What is your IIEF erectile function score? Find Out with the ED Severity Calculator

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ExcelMale Consensus

A normal IIEF erectile function score is 26 to 30 out of 30 on the six-question erectile function domain, or 22 to 25 out of 25 on the shorter IIEF-5. Scores below those ranges indicate erectile dysfunction, graded from mild down to severe.

Testosterone therapy alone raises the erectile function domain by about 2 to 3 points across three separate meta-analyses. That clears the 2-point threshold men with mild ED need to notice a difference, but falls short of the 5 points needed for moderate ED and the 7 needed for severe ED.

Score yourself on the six-question domain rather than all 15 questions, retest every 12 weeks using the same version, and bring the number and the date to your physician.

Key Takeaways

The six-question erectile function domain (questions 1 through 5 plus question 15) is what clinical trials report, scored out of 30.
The IIEF-5 and the SHIM are the same five-question instrument, scored out of 25.
How many points count as real improvement depends on where you started: 2 for mild, 5 for moderate, 7 for severe.
Testosterone alone averages a 2 to 3 point gain, which is why it resolves mild ED but often not moderate or severe ED.
Questions 1 through 5 score zero for no sexual activity, so a low-frequency month drags your score down independently of erectile capacity.
All 15 questions with their response options are included below as a printable worksheet with a blank score column.

Most men who take the IIEF questionnaire add up all fifteen answers, land on a number somewhere in the fifties, and have no idea whether that is good. The number is close to meaningless as calculated. Every clinical trial you have ever read about Cialis, avanafil, or testosterone reported something narrower: the six-question erectile function domain, scored out of 30. That is the number your urologist is thinking of when he asks about your IIEF, and it is the one worth learning to calculate.

The questionnaire has been posted on ExcelMale since 2015 and gets referenced constantly in study threads here. What has never been spelled out is how to score it on yourself and what to do with the result.

How Do You Score the IIEF Erectile Function Domain?

The full IIEF has 15 questions covering five domains: erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Rosen and colleagues validated it in Urology in 1997, and it remains the reference instrument in sexual medicine.

The erectile function domain (IIEF-EF) is the six-question subset that trials use as their primary endpoint: questions 1 through 5, plus question 15. Questions 1 through 5 score 0 to 5. Question 15, which asks about your confidence in getting and keeping an erection, scores 1 to 5. Add those six for a total between 1 and 30.

There is a shorter version you will also run into. The IIEF-5, also called the SHIM (Sexual Health Inventory for Men), uses five questions drawn from the longer instrument: items 2, 4, 5, and 15 from the erectile function domain, plus item 7 from intercourse satisfaction. It scores out of 25 and takes about a minute. Clinics use it for screening because it is fast.

The two versions use different scales and different cutoffs, and men mix them up all the time. That is how someone ends up reporting a score of 20 without saying whether it is 20 out of 25 or 20 out of 30. Those describe fairly different situations.

Which Version Should You Use to Track Yourself?

Use the IIEF-5 for quick repeat checks and the full EF domain if you want to compare yourself against published trial data. The EF domain is more sensitive to change over time, which matters if you are trying to tell whether a protocol adjustment did anything.

One scoring detail trips people up. Questions 1 through 5 award a zero for no sexual activity or did not attempt intercourse. A man who was not sexually active during the recall window scores near the floor regardless of his actual erectile capacity. Cappelleri and colleagues addressed this in the Journal of Sexual Medicine in 2016, noting that severe ED is scored 6 to 10, or 1 to 10 when men who did not attempt sexual activity are included. If you have not attempted intercourse in the past four weeks, your score will read worse than your physiology warrants.

What Are the 15 IIEF Questions? (Printable Worksheet)

Answer each question based on the past four weeks. Write your number in the score column. Items marked EF domain feed the six-question score out of 30, and items marked IIEF-5 feed the five-question short form out of 25. Several items count toward both.

Answer honestly rather than optimistically. A score you inflate is a score you cannot compare against your next one.

Question and response options	Score
Q1. How often were you able to get an erection during sexual activity? [EF domain] 0 No sexual activity 1 Almost never or never 2 A few times (less than half the time) 3 Sometimes (about half the time) 4 Most times (more than half the time) 5 Almost always or always	______
Q2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration? [EF domain, IIEF-5] 0 No sexual activity 1 Almost never or never 2 A few times (less than half the time) 3 Sometimes (about half the time) 4 Most times (more than half the time) 5 Almost always or always	______
Q3. When you attempted intercourse, how often were you able to penetrate (enter) your partner? [EF domain] 0 Did not attempt intercourse 1 Almost never or never 2 A few times (less than half the time) 3 Sometimes (about half the time) 4 Most times (more than half the time) 5 Almost always or always	______
Q4. During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner? [EF domain, IIEF-5] 0 Did not attempt intercourse 1 Almost never or never 2 A few times (less than half the time) 3 Sometimes (about half the time) 4 Most times (more than half the time) 5 Almost always or always	______
Q5. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse? [EF domain, IIEF-5] 0 Did not attempt intercourse 1 Extremely difficult 2 Very difficult 3 Difficult 4 Slightly difficult 5 Not difficult	______
Q6.How many times have you attempted sexual intercourse? 0 No attempts 1 One to two attempts 2 Three to four attempts 3 Five to six attempts 4 Seven to ten attempts 5 Eleven or more attempts	______
Q7. When you attempted sexual intercourse, how often was it satisfactory for you? [IIEF-5] 0 Did not attempt intercourse 1 Almost never or never 2 A few times (less than half the time) 3 Sometimes (about half the time) 4 Most times (more than half the time) 5 Almost always or always	______
Q8.How much have you enjoyed sexual intercourse? 0 No intercourse 1 No enjoyment at all 2 Not very enjoyable 3 Fairly enjoyable 4 Highly enjoyable 5 Very highly enjoyable	______
Q9.When you had sexual stimulation or intercourse, how often did you ejaculate? 0 No sexual stimulation or intercourse 1 Almost never or never 2 A few times (less than half the time) 3 Sometimes (about half the time) 4 Most times (more than half the time) 5 Almost always or always	______
Q10.When you had sexual stimulation or intercourse, how often did you have the feeling of orgasm or climax? 1 Almost never or never 2 A few times (less than half the time) 3 Sometimes (about half the time) 4 Most times (more than half the time) 5 Almost always or always	______
Q11.How often have you felt sexual desire? 1 Almost never or never 2 A few times (less than half the time) 3 Sometimes (about half the time) 4 Most times (more than half the time) 5 Almost always or always	______
Q12.How would you rate your level of sexual desire? 1 Very low or none at all 2 Low 3 Moderate 4 High 5 Very high	______
Q13.How satisfied have you been with your overall sex life? 1 Very dissatisfied 2 Moderately dissatisfied 3 Equally satisfied and dissatisfied 4 Moderately satisfied 5 Very satisfied	______
Q14.How satisfied have you been with your sexual relationship with your partner? 1 Very dissatisfied 2 Moderately dissatisfied 3 Equally satisfied and dissatisfied 4 Moderately satisfied 5 Very satisfied	______
Q15. How do you rate your confidence that you could get and keep an erection? [EF domain, IIEF-5] 1 Very low 2 Low 3 Moderate 4 High 5 Very high	______

Questionnaire reproduced from 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.

How Do You Total the Five Domains?

Add the listed questions for each domain. The erectile function domain is the one clinical trials report and the one worth tracking over time.

Domain	Questions to add	Possible range	Unaffected range
Erectile function (EF)	Q1 + Q2 + Q3 + Q4 + Q5 + Q15	1 to 30	26 to 30
Orgasmic function	Q9 + Q10	0 to 10	9 to 10
Sexual desire	Q11 + Q12	2 to 10	8 to 10
Intercourse satisfaction	Q6 + Q7 + Q8	0 to 15	10 to 15
Overall satisfaction	Q13 + Q14	2 to 10	8 to 10

For the IIEF-5 or SHIM, add questions 2, 4, 5, 7, and 15 for a total out of 25.

What Do the IIEF Severity Categories Mean?

The erectile function domain divides into five bands:

IIEF-EF score (out of 30)	Category
26 to 30	No erectile dysfunction
22 to 25	Mild ED
17 to 21	Mild to moderate ED
11 to 16	Moderate ED
6 to 10	Severe ED

The IIEF-5 or SHIM uses its own bands out of 25: 22 to 25 is no ED, 17 to 21 mild, 12 to 16 mild to moderate, 8 to 11 moderate, and 5 to 7 severe.

For context on where you sit relative to other men, Amand and colleagues surveyed 3,289 sexually active American men in 2021 and published the results in BMC Public Health in 2025. IIEF-5-defined ED ran 26.0% in men aged 18 to 34 and 62.5% in men 65 and older. Two things stand out. Men in their twenties and early thirties report ED at a rate that surprises most people. And self-perception ran consistently below questionnaire-defined prevalence, meaning a substantial number of men score in the ED range without thinking of themselves as having ED.

How Much Score Improvement Actually Counts as Real?

This is the part most men get wrong when they read trial results.

Rosen and colleagues published the minimal clinically important difference for the EF domain in European Urology in 2011, pooling 17 randomized placebo-controlled tadalafil trials covering 3,345 men. The MCID is the smallest change a man actually notices as a benefit. Overall it came out to 4 points. The finding that matters more is that it scales with baseline severity:

Baseline ED severity	Points needed to notice a difference
Mild	2
Moderate	5
Severe	7

A 3-point gain means something quite different depending on where you started. If you began at 24 with mild ED, 3 points is a real improvement you would feel. If you began at 12 with moderate ED, the same 3 points sits below the threshold at which men report noticing anything.

Keep this table handy when you read study abstracts. A trial reporting a statistically significant 2-point gain in a moderate-to-severe population has demonstrated a result that its own participants would likely not perceive.

How Much Does Testosterone Alone Move Your IIEF Score?

Here is the number that reframes a complaint I see constantly on this forum: my testosterone is optimized and my erections still are not right.

Corona and colleagues pooled 14 placebo-controlled trials covering 2,298 men in European Urology in 2017. Testosterone therapy improved the IIEF-EF domain by a mean of 2.31 points over placebo (95% CI 1.41 to 3.22). Xu and colleagues ran an updated meta-analysis of 28 randomized trials and 3,461 patients in Frontiers in Endocrinology in 2024, finding a weighted mean IIEF improvement of 3.26 points (95% CI 1.65 to 4.88). The 2025 Cochrane review, published in abridged form by Lee and colleagues in the World Journal of Men's Health, put the IIEF-EF mean difference at 2.37 points across 6 trials and 2,016 participants, and graded it moderate-certainty evidence.

Three independent analyses converge on roughly 2 to 3 points.

Now put that next to the MCID table. Two to three points clears the 2-point threshold for mild ED comfortably. It falls short of the 5 points needed for moderate ED and well short of the 7 for severe. Testosterone alone reliably fixes mild erectile dysfunction in hypogonadal men. For moderate or severe ED, the expected gain from testosterone by itself sits below what men perceive as improvement.

That is not a protocol failure. It is arithmetic, and knowing it in advance saves a lot of dose chasing.

Corona's data adds two qualifiers worth knowing. Men who started with more severe hypogonadism gained more: 2.95 points for those below 8 nmol/L versus 1.47 points for those below 12 nmol/L. And the effect shrank in men with diabetes or obesity. If you are metabolically unhealthy and moderately hypogonadal, expect testosterone to do less for your erections than the headline numbers suggest.

This is why the 2025 European Association of Urology guidelines, updated by Salonia and colleagues, treat erectile dysfunction as a workup rather than a hormone problem. The recommended basic evaluation includes a validated questionnaire alongside fasting glucose or HbA1c, a lipid profile, and early morning fasting total testosterone. ED correlates strongly with cardiovascular disease and can show up before other symptoms.

What Does Your IIEF Score Not Tell You?

The questionnaire has real limits, and I have flagged them on the forum since first posting it.

It barely touches psychosexual background and says almost nothing about your relationship, both of which drive a large share of erectile complaints. Treat the score as an adjunct to a proper sexual history rather than a substitute for one.

It also cannot distinguish vascular from psychogenic from medication-related causes. A 14 tells you where you are, not why. Answering the same questionnaire honestly across two sets of circumstances, a stressful quarter at work versus a relaxed vacation, can produce a meaningfully different number with no change to your vascular health.

Nor does it replace objective testing. Nocturnal penile tumescence testing and penile duplex ultrasound answer questions the questionnaire cannot.

What it does well is track you against yourself. A score taken before a protocol change and again 12 weeks later, using the same version and answered honestly, tells you more than either score alone.

How Should You Use Your Score With Your Doctor?

Bring the number, the version you used, and the date. An IIEF-EF of 18 out of 30 on March 3 gives a urologist something concrete to work with. My erections have been off lately does not.

The original ExcelMale post laid out a practical framework that still holds up. Scores below 14 on the erectile function domain warrant discussing a PDE5 inhibitor trial along with a testosterone blood test. Low scores on the orgasmic and ejaculatory questions point toward a urology referral rather than a hormone adjustment. Reduced sexual desire calls for testosterone and prolactin testing, since elevated prolactin is a treatable cause that gets missed. And when desire and satisfaction scores are low while the erectile function domain sits in the moderate range of 14 to 25, psychosexual counseling belongs in the conversation.

That last pattern comes up regularly here, and it is the one men resist most.

Frequently Asked Questions

What is a normal IIEF score for a man without erectile dysfunction?

On the six-question erectile function domain, 26 to 30 out of 30 indicates no erectile dysfunction. On the five-question IIEF-5 or SHIM, the equivalent range is 22 to 25 out of 25.

Is the IIEF-5 the same thing as the SHIM?

Yes. The Sexual Health Inventory for Men is the five-item abridged version of the IIEF, scored out of 25. The names get used interchangeably in the literature.

How many points of improvement should I expect from TRT?

Roughly 2 to 3 points on the erectile function domain, based on three separate meta-analyses. That is enough to be noticeable if your ED is mild, and generally not enough on its own if it is moderate or severe.

Why did my score drop when nothing changed physically?

The first five questions award zero for no sexual activity or no attempted intercourse during the four-week recall window. A period of low frequency pushes your score down independently of erectile capacity. Compare scores from windows with similar activity levels.

How often should I retake the questionnaire?

Every 12 weeks is reasonable, and it matches the timeframe most trials use to measure treatment response. Retaking it weekly adds noise without adding information.

Conclusion

One thing the score sheets never mention: the four-week recall window means your IIEF is partly a measure of your last month's circumstances, not just your vascular health. Men who travel for work, or whose partner was away, or who simply had a bad stretch, routinely score themselves into a worse category than their physiology deserves and then chase a dose change they did not need. Before you act on a drop, ask whether the month itself changed.

If your score stayed low after a solid month, the Persistent Sexual Dysfunction and Abnormal Lab Results thread walks through what to check next, and Cialis is not working covers the iron and nitric oxide angles most physicians skip.

Related ExcelMale Forum Discussions

International Index of Erectile Function (IIEF) Questionnaire: What's Your Score?. Companion thread where members posted and compared scores.
What is your IIEF erectile function score? (When TRT Is Not Enough). The same questionnaire in the ED and libido subforum.
Persistent Sexual Dysfunction and Abnormal Lab Results. An active case of sexual dysfunction that persisted despite lab work, showing why scores and labs need reading together.
Cialis is not working. Members discuss ferritin, iron status, and nitric oxide as reasons PDE5 inhibitors stop working.
Cialis Not Working, Highest Dosage?. Dose escalation, manufacturer differences, and the role of estradiol in PDE5 response.
Daily Cialis Plus Trimix?. Long-running thread on combining daily tadalafil with injectable therapy.
First time with Trimix, my experience. A first-hand account of dosing and syringe selection for men whose scores stay low on oral agents.
Efficacy and safety of avanafil compared with sildenafil. Head-to-head trial data reported in IIEF-EF points.
Daily tadalafil for ED and premature ejaculation. Study thread using IIEF-5 scores as the outcome measure.
Completely different states of arousal: Androgel vs. Cypionate. Member discussion of how delivery method changed subjective sexual response.

Key References

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. Redirecting
Rosen RC, Allen KR, Ni X, Araujo AB. Minimal Clinically Important Differences in the Erectile Function Domain of the International Index of Erectile Function Scale. European Urology, 2011. Redirecting
Cappelleri JC, et al. Simplified Interpretation of the Erectile Function Domain of the International Index of Erectile Function. The Journal of Sexual Medicine, 2016. https://doi.org/10.1016/j.jsxm.2016.02.159
Corona G, et al. Meta-analysis of Results of Testosterone Therapy on Sexual Function Based on International Index of Erectile Function Scores. European Urology, 2017. Redirecting
Ponce OJ, et al. The Efficacy and Adverse Events of Testosterone Replacement Therapy in Hypogonadal Men: A Systematic Review and Meta-Analysis of Randomized, Placebo-Controlled Trials. The Journal of Clinical Endocrinology and Metabolism, 2018. https://doi.org/10.1210/jc.2018-00404
Xu Z, et al. An updated systematic review and meta-analysis of the effects of testosterone replacement therapy on erectile function and prostate. Frontiers in Endocrinology, 2024. Frontiers | An updated systematic review and meta-analysis of the effects of testosterone replacement therapy on erectile function and prostate
Lee J, et al. Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic Review. The World Journal of Men's Health, 2025. Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic Review
Salonia A, et al. European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2025 Update. European Urology, 2025. Redirecting
Amand C, et al. A population-based survey of self-reported and IIEF-defined erectile dysfunction among adult men in the United States in 2021. BMC Public Health, 2025. https://doi.org/10.1186/s12889-025-24808-4
Diaz-Mohedo E, et al. The Spanish Version of the International Index of Erectile Function: Adaptation and Validation. International Journal of Environmental Research and Public Health, 2023. https://doi.org/10.3390/ijerph20031830

Medical Disclaimer

This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting or modifying any hormone therapy or medical treatment.

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