This information is vital for two reasons: firstly, to have an initial assessment of the condition against which you can measure improvement; and secondly, to help make a decision on the mode of treatment which best suits the patient.
Prior to the release of Viagra, the medical community was becoming aware of the potential impact that this drug would
have on the world. There was also a concern that doctors would be unprepared when the predicted massive influx of patients with erectile dysfunction occurred. The majority of medical practitioners worldwide have little experience in treating this condition. That is to say, when most doctors were trained, the approach to the treatment of erectile dysfunction was completely different to what is prescribed today. For the 'old school', the options are still psychotherapy, hormone replacement therapy or referral to a specialist such as myself.
Viagra has brought the treatment of erectile dysfunction into the general practice setting. This simple approach now allows millions of men to see their primary care physician rather than waiting to see a specialist. It is therefore necessary to prepare all general practitioners adequately for the inevitable increase in patients requesting this treatment.
In 1997, world leaders in sexual medicine researched and developed a questionnaire that would assist with the diagnosis of a patient with erectile dysfunction. This simple questionnaire was based on the International Index of Erectile Function (IIEF) and is called the 'Sexual Health Inventory for Men'. It can be filled out and scored by a patient, allowing the doctor to identify and to assess the severity of the problem.
The shortened version of this International Index contains five questions that focus on erectile dysfunction:
1.         How do you rate your confidence about getting and keeping an erection?
2.         When you had an erection with sexual stimulation, how often was it hard enough for penetration?
3.         During sexual intercourse, how often were you able to maintain your erection after you penetrated (entered) your partner?
4.         During sexual intercourse, how difficult was it to maintain your erection to the completion of intercourse?
5.         When you attempted sexual intercourse, how often was it satisfactory for you?
Each question has a response scale of o to 5, ranging from the most negative (o) to the most positive response (5). If the patient has a score of 21 or less, then he can be considered as having some degree of erectile dysfunction. A score of 20 would indicate only mild problems with erectile functioning. The lower the score, the greater the degree of erectile dysfunction. It is also a useful method in monitoring the effects of treatment. The drawback of this simplified questionnaire is that it does not adequately address patient satisfaction with their erection or the quality of the erection during masturbation or the partner's response.

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