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IIEF-5 Erectile Dysfunction Self-Test (5 questions)

Take the validated 5-question IIEF-5 erectile dysfunction self-test in 60 seconds. Rosen 1999, AUA-anchored. Free, no signup, no email

Last updated: Sources verified:

What you are about to take

The IIEF-5 measures how well erections have worked over the past 6 months across 5 short questions. Score 5-25; the band you fall into matters more than the absolute number. About 60 seconds. No signup. Raymond Rosen and colleagues published the IIEF-5 in 1999 (Int J Impot Res, PMID 10637462) as an abridged office version of the original 15-item IIEF, and the American Urological Association lists it as the primary screener for ED. Your answers stay in your browser — we never see them. Start the test below ↓

✓ Validated by Rosen et al. (1999, Int J Impot Res) ✓ Listed in AUA 2018 ED guideline as primary office screener ✓ 60 seconds, 5 questions ✓ Private — answers never leave your device

How the IIEF-5 is scored

Each of the 5 questions is answered on a 1-5 Likert scale. The total ranges 5-25. Bands are from Rosen 1999.

Total scoreBandWhat the band typically means
22-25No erectile dysfunctionNormal function over the past 6 months
17-21Mild EDFunction reduced but mostly working — reversible contributors worth checking
12-16Mild-to-moderate EDRoutine interference — primary-care or urology visit recommended
8-11Moderate EDConsistent disruption — doctor visit this week, treatments work
5-7Severe EDIntercourse essentially not happening — urology referral reasonable

Rosen 1999 reported sensitivity of about 0.98 and specificity of about 0.88 at the cutoff of 21 for detecting any ED. That makes the IIEF-5 a strong screener — it rarely misses real ED — but a 12% false-positive rate means a clinician’s interview is still the final word.

When this test is useful — and when it isn’t

Useful for:

  • Putting a number on something that has been hard to discuss
  • Tracking change across quarters during treatment or lifestyle adjustment
  • Bringing a quantified score to a GP or urology visit instead of a vague “things aren’t working”

Not useful for:

  • Diagnosing ED — only a clinician can do this with history, exam, and labs
  • Measuring desire, ejaculation, or relationship satisfaction — those are separate dimensions (the full 15-item IIEF covers them)
  • A single bad episode — the test asks about the past 6 months, not a stressful weekend

ED is a medical question, not a moral one

About 1 in 3 men over 40 has some level of ED (Wessells 2008, Campbell-Walsh Urology). It is one of the most common conditions in primary care, and one of the most under-discussed. The biology is straightforward: erection is largely a vascular event, and the penile arteries are smaller than the coronary arteries — so they narrow earlier (Montorsi 2005, Am J Cardiol). New-onset ED in a man under 60 is treated by the AUA 2018 guideline as a recognized flag for a cardiovascular workup, not as an isolated bedroom problem.

The reversible contributors usually act in combinations: smoking, untreated sleep apnea, alcohol most evenings, sedentary work, weight gain, an SSRI started for anxiety, a beta-blocker for blood pressure, a finasteride for hair. Esposito 2004 (JAMA) showed that lifestyle change measurably improved IIEF scores within 2 years. Quitting smoking moves the needle quickly. Treating apnea moves it within months. PDE5 inhibitors (sildenafil, tadalafil, vardenafil) work in roughly 70% of unselected men (Hatzimouratidis 2010, European Urology) and are safe with most medications except nitrates.

If the standard ladder is not enough, the second and third lines exist for a reason: vacuum erection devices, intracavernosal injection, intraurethral therapy, penile prosthesis. Across the full ladder, the proportion of men achieving satisfactory intercourse exceeds 90% — but it usually takes more than the first option tried.

What to do at each band

  • 22-25 (no ED): Nothing required from this screener. Keep cardiovascular basics in place (exercise, no smoking, normal BMI, moderate alcohol) and retake if anything changes.
  • 17-21 (mild): Look at reversible contributors first (sleep, alcohol, new medications, stress). Retake in 4-8 weeks. If self-care does not move it, GP visit.
  • 12-16 (mild-to-moderate): GP visit within 4 weeks. Bring the score. Ask for BP, lipid panel, fasting glucose or HbA1c, morning testosterone. Review every medication.
  • 8-11 (moderate): GP visit this week. Same workup plus TSH. Ask about PDE5 inhibitors (tadalafil daily 2.5-5 mg often suits this band).
  • 5-7 (severe): GP visit this week and ask for urology referral. Cardiovascular workup before or alongside. Address mood — PHQ-9 on this site is a starting point; treating depression often partially restores function.
  • PHQ-9 depression screener — depression and ED are bidirectionally linked; about 1 in 3 men with ED has clinically significant depression (Goldstein 2000, J Urol)
  • GAD-7 anxiety screener — performance anxiety and generalized anxiety both feed ED
  • BMI calculator — obesity is one of the most modifiable ED risk factors (Esposito 2004, JAMA)

Sources verified 2026-05-17

  • Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM. 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;11(6):319-326. (PMID 10637462)
  • Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA Guideline. American Urological Association 2018, amended 2024.
  • Hatzimouratidis K, Amar E, Eardley I, et al. Guidelines on Male Sexual Dysfunction. European Association of Urology / Eur Urol 2010;57(5):804-814. (PMID 20122481)
  • Wessells H. Erectile Dysfunction. Campbell-Walsh Urology, 9th ed., 2008.
  • Montorsi P, Ravagnani PM, Galli S, et al. The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease. Am J Cardiol 2005;96(12B):19M-23M. (PMID 15936139)
  • Mayo Clinic. Erectile dysfunction — symptoms and causes. Patient resource, reviewed 2024.

Privacy

The IIEF-5 calculation runs entirely in your browser. Your individual answers and the calculated band never leave your device. We send one anonymous event to a privacy-respecting analytics service: your locale code and the band string (for example mild_ed). No raw answers, no per-item data, no identifier of any kind.

Frequently asked questions

What does an IIEF-5 score of 17 mean?
A score of 17 sits at the top of the mild ED band (17-21). Rosen 1999 (Int J Impot Res, PMID 10637462) defined this range as reduced erectile function that is still functional most of the time. AUA 2018 treats this band as a watchful-waiting threshold — review reversible contributors (sleep, alcohol, new medications, stress) before adding a prescription. About 1 in 4 men under 50 score here at some point (Feldman 1994, Massachusetts Male Aging Study).
What does an IIEF-5 score of 15 mean?
A score of 15 places you in the mild-to-moderate ED band (12-16). Rosen 1999 set this as the band where erectile function fails routinely, not occasionally. AUA 2018 and Hatzimouratidis 2010 (European Urology) both recommend a primary-care or urology visit at this level for a standard workup: blood pressure, lipid panel, fasting glucose or HbA1c, and morning testosterone.
What does an IIEF-5 score of 10 mean?
A score of 10 is in the moderate ED band (8-11). Erections fail or are insufficient most of the time. At this level a doctor visit this week is reasonable — and several effective treatments are available. PDE5 inhibitors (sildenafil, tadalafil) work in roughly 70% of unselected patients (Hatzimouratidis 2010, European Urology); tadalafil daily low-dose often suits moderate ED better than on-demand dosing.
At what IIEF-5 score is erectile dysfunction diagnosed?
Rosen 1999 defined the clinical cutoff at 21: scores of 22-25 fall in the no-ED band, and 21 or below indicates some degree of ED. The IIEF-5 has sensitivity around 0.98 and specificity around 0.88 at this cutoff (Rosen 1999), so a low score is a strong signal for clinical evaluation, but the diagnosis itself comes from a doctor's history-taking, examination, and bloods — not from the questionnaire alone.
IIEF-5 = 14, should I see a doctor?
Yes. A score of 14 is mid-range in the mild-to-moderate band (12-16). AUA 2018 and Hatzimouratidis 2010 list this band as the point where evaluation is recommended over wait-and-see. Bring the score to your GP and ask for the standard workup: BP, lipids, fasting glucose or HbA1c, morning testosterone. Many cases at this level respond well to PDE5 inhibitors plus correction of reversible contributors.
IIEF-5 vs SHIM — what is the difference?
There is no difference. The IIEF-5 is also known as the SHIM (Sexual Health Inventory for Men). Rosen 1999 introduced the abridged 5-item version of the original 15-item IIEF (Rosen 1997, Urology) and labeled it SHIM in clinical contexts. The bands, scoring, and validation are identical — only the name differs.
Is erectile dysfunction reversible?
Often, yes. Wessells 2008 (Campbell-Walsh Urology) notes that the most common reversible contributors are smoking, sedentary lifestyle, obesity, untreated sleep apnea, alcohol, anxiety, and medication side-effects (SSRIs, thiazides, beta-blockers, finasteride). Esposito 2004 (JAMA) showed that lifestyle change improved IIEF scores measurably within 2 years in obese men. PDE5 inhibitors restore function for roughly 70% of users when self-care is not enough.
ED at age 40 vs ED at age 60 — what changes?
Prevalence rises with age, but the diagnostic and treatment ladder is the same. Feldman 1994 (Massachusetts Male Aging Study) found around 40% of men had some ED at 40 and around 70% at 70. Younger men are more often vascular-warning cases — ED in a man under 50 is a recognized indication for a cardiovascular workup (Montorsi 2005, Am J Cardiol). Older men are more likely to have prostate-surgery, diabetes, or medication-related ED.
Can erectile dysfunction be a sign of heart disease?
Yes. Montorsi 2005 (Am J Cardiol) showed that ED precedes a coronary event by an average of 2-3 years in men who later have one. The penile arteries are smaller than the coronary arteries, so they narrow earlier — the same atherosclerosis. AUA 2018 treats new-onset ED in a man under 60 as a flag for blood pressure, lipid, and fasting-glucose checks.
What causes erectile dysfunction?
Mostly vascular. Wessells 2008 (Campbell-Walsh Urology) groups causes as vascular (most common in men over 40 — same risk factors as heart disease), neurological (diabetic neuropathy, post-prostatectomy), hormonal (low testosterone, thyroid), medication-induced (SSRIs, blood-pressure drugs, finasteride), and psychogenic (performance anxiety, depression, relationship strain). Most real-world cases are a mix.
How often should I retake the IIEF-5?
Every 3-6 months during active treatment or lifestyle change, or any time something major shifts — a new medication, a major life event, or a change in your relationship. The questionnaire asks about the past 6 months, so weekly retakes are noise. A 4-6 point shift across a quarter is a real clinical signal.
Can performance anxiety alone cause a low IIEF-5 score?
Yes. Anxiety-driven ED is real and is often situational — strong morning erections but failure with a partner are a classic pattern. Hatzimouratidis 2010 (European Urology) lists psychogenic ED as a distinct category. CBT for performance anxiety often raises the score on its own, and PDE5 inhibitors can break the avoidance cycle quickly when used short-term.
Can the IIEF-5 give a false positive?
Occasionally. Rosen 1999 reports sensitivity around 0.98 and specificity around 0.88 at the cutoff of 21 — meaning out of 100 men scoring 21 or below, roughly 12 are false positives. Recall bias matters too: a stressful 6 months can drop the score without an underlying medical cause. A confirmation conversation with a clinician is the next step, not a self-diagnosis.
Is the IIEF-5 the same questionnaire urologists use?
Yes. AUA 2018 lists the IIEF-5/SHIM as the primary office screener for ED. The wording on this page is the standard public paraphrase used in AUA patient education and validation studies. The same 5 questions, the same 5-25 score, the same Rosen 1999 bands.
Is my data private?
Yes. The IIEF-5 runs entirely in your browser. Your individual answers never leave your device. We log one anonymous event with the IIEF-5 band string (e.g. `mild_ed`) — no raw answers, no IP, no identifier of any kind.

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Sources

  1. 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 — Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM — Int J Impot Res (1999) (peer reviewed, retrieved 2026-05-17)
  2. Erectile Dysfunction: AUA Guideline — American Urological Association (Burnett et al., 2018, amended 2024) (guideline, retrieved 2026-05-17)
  3. Guidelines on Male Sexual Dysfunction: Erectile Dysfunction and Premature Ejaculation — Hatzimouratidis K, Amar E, Eardley I, et al. — European Association of Urology (Eur Urol 2010) (guideline, retrieved 2026-05-17)
  4. Erectile dysfunction (chapter on epidemiology and risk factors) — Wessells H — in Wein AJ (ed.), Campbell-Walsh Urology (2008) (peer reviewed, retrieved 2026-05-17)
  5. The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease — Montorsi P, Ravagnani PM, Galli S, et al. — Am J Cardiol (2005) (peer reviewed, retrieved 2026-05-17)
  6. Mayo Clinic — Erectile dysfunction overview, symptoms, causes — Mayo Clinic (patient resource, last reviewed 2024) (medical society, retrieved 2026-05-17)