Please answer the following questions based on the actual situation of your sexual life in the past 6 months.
Q1 What is your usual level of sexual desire or interest?
1. very low
2. low
3. average Liu Lei, Department of Urology, Zunyi First People’s Hospital
4. high
5. very high
Q2 How often is the erection hard enough to penetrate the vagina during sex?
1. hardly ever
2. a few times
3. about half of the time
4. most of the time
5. almost always
Q3 Frequency of being able to maintain an erection until the end of sexual intercourse
1. hardly ever
2. a few times
3. about half of the time
4. most of the time
5. almost always
Q4 During sex, how long does it take from penile insertion into the vagina until ejaculation
1. very short (<30 seconds)
2. very short (1 minute)
3. short (2 minutes)
4. relatively short (3 minutes)
5. Not short (>3 minutes)
Q5 How difficult is it for you to try to prolong intercourse during sex?
1. very difficult
2. difficult
3. somewhat difficult
4. average
5. not difficult
Q6 In general, how satisfied are you with your sex life?
1. Very dissatisfied
2. not satisfied
3. average
4. Satisfied
5. very satisfied
Q7 In general, how satisfied is your spouse with your sex life?
1. very dissatisfied
2. dissatisfied
3. average
4. Satisfied
5. very satisfied
Q8 How often does your spouse achieve orgasm during sex?
1. hardly ever
2. a few times
3. about half of the time
4. most of the time
5. almost always
Q9 How confident do you feel about having a successful sex life?
1. very low
2. Low
3. average
4. confident
5. very confident
Q10 How often do you feel anxious, nervous or uneasy during sex?
1. Almost always
2. Most of the time
3. usually
4. a few times
5. hardly ever
1 for option 1 of the above answers. 2 for option 2. 3 for option 3. 4 for option 4. 5 for option 5.
Severe: 5-15 points Moderate: 16-30 points Mild: 31-40 points