IIEF-15: Unsuitable for assessing erectile function of young men?
Abstract
INTRODUCTION: The prevalence of erectile dysfunction (ED) is mainly studied in older males, whereas we measured prevalence of ED in young healthy males using a validated questionnaire. AIM: Assessing the prevalence of ED in young adult men using the International Index of Erectile Function (IIEF-15) and creating a benchmark for ED in this young age group for further research. METHODS: Male students were randomly asked to participate. Men with history of sexual dysfunction or urologic disease were excluded. Age, having a relationship and the IIEF-15 were filled out anonymously and in private. Outcomes of all domains were separately analysed based on relationship and intercourse frequency. MAIN OUTCOME MEASURES: ED measured by the IIEF-15. RESULTS: One hundred and fifty-one students, aged 21.8 years (17-35, SD 2.98) participated and 14 were excluded. Of 137 students, 81% reported to have an intimate relationship. ED appeared to be present in 46 students (33.6%). The answer "no sexual activity," resulting in a 0-score, was given inconsistently. Outcomes were analysed for students who gave this answer at least once compared with those who never did. Nobody had ED in the group "without 0-scores" (n = 91). All students in the group "with (inconsistent) 0-scores" (n = 46) had ED. Students with a relationship had ED in 24.3% compared with 73.1% in those without a relationship (P < 0.001). CONCLUSION: When men with inconsistently answered IIEF-15 questionnaires are excluded, a 0% prevalence of ED is found in this age-group. The current scoring method however does not state that these questionnaires should be excluded, and results in a prevalence of ED of 34%. Possibly, the scoring method of the IIEF-15 needs to be reviewed when this questionnaire is used in young, healthy men in order to accurately measure the prevalence of ED.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Such measures are therefore less suited to measure the sexual experiences of single men and men who have sex with men.
“Such measures are therefore less suited to measure the sexual experiences of single men and men who have sex with men.80, 81, 82”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [81]
The vast majority of ED case-history tools does not take diversity into account because they are mainly oriented towards heterosexual couples in stable relationship and/or to men who have experienced sexual intercourse in the last 4 weeks preceding the evaluation.
“Furthermore, the vast majority of ED case-history tools does not take diversity into account because they are mainly oriented towards heterosexual couples in stable relationship and/or to men who have experienced sexual intercourse in the last 4 weeks preceding the evaluation (eg, International Index of Erectile Function).”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [81]
Cites
Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997) · Urology · doi:10.1016/s0090-4295(97)00238-0 · Cited by 5,849 · see citing works
(1993) · JAMA · doi:10.1001/jama.1993.03510010089036 · Cited by 1,629 · see citing works
Rosen, R., Altwein, J., Boyle, P., Kirby, R. S., Lukacs, B., Meuleman, E., O’Leary, M. P., Puppo, P., Robertson, C., & Giuliano, F. (2003) · European Urology · doi:10.1016/j.eururo.2003.08.015 · Cited by 1,118 · see citing works
The International Index of Erectile Function (IIEF): a state-of-the-science review
Rosen, R., Cappelleri, J. C., & Gendrano, N. (2002) · International Journal of Impotence Research · doi:10.1038/sj.ijir.3900857 · Cited by 1,045 · see citing works
Epidemiology of erectile dysfunction: results of the ‘Cologne Male Survey’
Braun, M., Wassmer, G., Klotz, T. H., Reifenrath, B., Mathers, M., & Engelmann, U. (2000) · International journal of impotence research · doi:10.1038/sj.ijir.3900622 · Cited by 981 · see citing works
(1999) · doi:10.1016/s0090-4295(99)00099-0 · Cited by 897 · see citing works
Porst, H., Montorsi, F., Rosen, R. C., Gaynor, L., Grupe, S., & Alexander, J. R. (2006) · European Urology · doi:10.1016/j.eururo.2006.07.004 · Cited by 587 · see citing works
Martín‐Morales, A., Sánchez-Cruz, J. J., de Tejada, I. S., Rodriguez-Vela, L., Jiménez-Cruz, J. F., & BURGOS-RODRIGUEZ, R. (2001) · The Journal of Urology · doi:10.1016/s0022-5347(05)65986-1 · Cited by 551 · see citing works
Prevalence and Risk Factors for Erectile Dysfunction in 2869 Men Using a Validated Questionnaire
PONHOLZER, A., TEMML, C., MOCK, K., MARSZALEK, M., OBERMAYR, R., & MADERSBACHER, S. (2005) · European Urology · doi:10.1016/j.eururo.2004.08.017 · Cited by 361 · see citing works
Prevalence of erectile dysfunction: a systematic review of population-based studies
Prins, J. T. H., Blanker, M. H., Bohnen, A. M., Thomas, S., & Bosch, J. L. H. R. (2002) · International Journal of Impotence Research · doi:10.1038/sj.ijir.3900905 · Cited by 278 · see citing works
Seksuele gezondheid in Nederland
(2007) · Huisarts en Wetenschap · doi:10.1007/bf03085175 · Cited by 89 · see citing works
Schouten, B., Bosch, J. L. H. R., Bernsen, R. M. D., Blanker, M. H., Thomas, S., & Bohnen, A. M. (2004) · International Journal of Impotence Research · doi:10.1038/sj.ijir.3901264 · Cited by 83 · see citing works
Prevalence of Erectile Dysfunction Among Young Adults: Results of a Large-Scale Survey
Heruti, R. J., Shochat, T., Tekes-Manova, D., Ashkenazi, I., & Justo, D. (2004) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.04041.x · Cited by 76 · see citing works
Erectile dysfunction in primary care: prevalence and patient characteristics. The ENIGMA study
de Boer, B.-J., Bots, M. L., Nijeholt, A. A. B. L. À., Moors, J., Pieters, H. M., & Verheij, T. J. M. (2004) · International Journal of Impotence Research · doi:10.1038/sj.ijir.3901155 · Cited by 73 · see citing works
Korkes, F., Costa‐Matos, A., Gasperini, R., Reginato, P. V., & Perez, M. D. (2008) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2008.00792.x · Cited by 52 · see citing works
The Prevalence of Bother, Acceptance, and Need for Help in Men with Erectile Dysfunction
de Boer, B.-J., Bots, M. L., Nijeholt, A. A. B. L. À., & Verheij, T. J. M. (2005) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2005.20364.x · Cited by 49 · see citing works
Eisenberg, M. L., Shindel, A. W., Smith, J. F., Lue, T. F., & Walsh, T. J. (2009) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01327.x · Cited by 23 · see citing works
[Erectile dysfunction: prevalence and effects on the quality of life: the Boxmeer study].
Blanker, M. H., Thomas, S., & Bosch, J. L. H. R. (2001) · PubMed · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Dewitte, M., Bettocchi, C., Carvalho, J., Corona, G., Flink, I., Limoncin, E., Pascoal, P., Reisman, Y., & Van Lankveld, J. (2021) · Sexual Medicine · doi:10.1016/j.esxm.2021.100434 · Cited by 97 · see citing works
For the CTMH-AFU group, Lebdai, S., Chevrot, A., Doizi, S., Pradère, B., Delongchamps, N. B., Fegoun, A. B. E., Cornu, J., Negra, E. D., Fourmarier, M., et al. (2018) · World Journal of Urology · doi:10.1007/s00345-018-2368-6 · Cited by 70 · see citing works
Kellesarian, S. V., Malignaggi, V. R., Feng, C., & Javed, F. (2018) · International Journal of Impotence Research · doi:10.1038/s41443-018-0017-7 · Cited by 58 · see citing works
Fraumann, S., Stephany, H. A., Clayton, D. B., Thomas, J. C., POPE, J. C. I., Adams, M. C., Brock, J. W. I., & Tanaka, S. T. (2014) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2014.01.015 · Cited by 41 · see citing works
Kim, J. K., Cho, M. C., Son, H., Ku, J. H., Oh, S., & Paick, J. (2016) · Urology · doi:10.1016/j.urology.2016.09.037 · Cited by 38 · see citing works
Jern, P., Gunst, A., Sandnabba, K. N., & Santtila, P. O. (2012) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2012.665818 · Cited by 36 · see citing works
Harte, C. B., & Meston, C. M. (2012) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2012.02755.x · Cited by 34 · see citing works
Herkommer, K., Meissner, V. H., Dinkel, A., Jahnen, M., Schiele, S., Kron, M., Ankerst, D. P., & Gschwend, J. E. (2023) · Andrology · doi:10.1111/andr.13524 · Cited by 34 · see citing works
Updating the International Index of Erectile Function: Evaluation of a Large Clinical Data Set
Vickers, A. J., Tin, A. L., Singh, K., Dunn, R. L., & Mulhall, J. P. (2019) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2019.10.020 · Cited by 32 · see citing works
Korneyev, I. A., Alexeeva, T. A., Al-Shukri, S. H., Bernikov, A. N., Еркович, А. А., Kamalov, A. A., Коган, М. И., Павлов, В. Н., Журавлев, В. Н., & DIu, P. (2016) · International Journal of Impotence Research · doi:10.1038/ijir.2016.8 · Cited by 29 · see citing works
Rynja, S. P., de Jong, T. P. V. M., Bosch, J. L. H. R., & de Kort, L. M. O. (2018) · British Journal of Urology · doi:10.1111/bju.14234 · Cited by 25 · see citing works
Self-citationDargis, L., Trudel, G. A., Cadieux, J., Villeneuve, L., Préville, M., & Boyer, R. (2012) · Sexologies · doi:10.1016/j.sexol.2012.01.001 · Cited by 23 · see citing works
Whelan, G., & Brown, J. (2021) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2021.06.014 · Cited by 20 · see citing works
A Survey of Obesity and Erectile Dysfunction of Men Conscripted into the Military in Taiwan
Chao, J., Hwang, T. I., Ma, M.-C., Kuo, W., Liu, J.-H., Chen, Y.-P., & Lin, Y. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02181.x · Cited by 20 · see citing works
Comparison of preputioplasty and circumcision in distal hypospadias correction: long-term follow-up
van den Dungen, I. A. L., Rynja, S. P., Bosch, J. L. H. R., de Jong, T. P. V. M., & de Kort, L. M. O. (2018) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2018.08.001 · Cited by 18 · see citing works
Self-citationTrudel, G. A., Dargis, L., Villeneuve, L., Cadieux, J., Boyer, R., & Préville, M. (2013) · Sexologies · doi:10.1016/j.sexol.2013.03.007 · Cited by 17 · see citing works
Rowe, C. K., Shnorhavorian, M., Block, P., Ahn, J. J., & Merguerian, P. A. (2018) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2018.05.029 · Cited by 15 · see citing works
Chen, T., Bhambhvani, H. P., Kasman, A. M., & Eisenberg, M. L. (2021) · Sexual Medicine · doi:10.1016/j.esxm.2021.100340 · Cited by 14 · see citing works
Garimella, P. S., Paudel, M. L., Ensrud, K. E., Marshall, L. M., Taylor, B. C., & Fink, H. A. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12073 · Cited by 14 · see citing works
Harte, C. B. (2013) · The Journal of Sexual Medicine · doi:10.1111/jsm.12197 · Cited by 12 · see citing works
Lovegrove, C. E., Ficarra, V., Montorsi, F., N'Dow, J. M., Salonia, A., & Minhas, S. (2019) · International Journal of Impotence Research · doi:10.1038/s41443-019-0220-1 · Cited by 12 · see citing works
Huang, Y., Liu, W., Liu, Y., Zhang, M., Xu, S., & Lu, M. (2020) · Andrologia · doi:10.1111/and.13745 · Cited by 12 · see citing works
Huang, Y., Chen, B., Yao, F., Chen, S., Ouyang, B., Deng, C., & Huang, Y. (2014) · The Journal of Sexual Medicine · doi:10.1111/jsm.12460 · Cited by 11 · see citing works
Harte, C. B. (2014) · The Journal of Sexual Medicine · doi:10.1111/jsm.12486 · Cited by 9 · see citing works
Jiann, B. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2011.02521.x · Cited by 8 · see citing works
Trudel, G. A., Dargis, L., Villeneuve, L., Cadieux, J., Boyer, R., & Préville, M. (2013) · Sexologies · doi:10.1016/j.sexol.2013.03.004 · Cited by 7 · see citing works
Trudel, G. A., Dargis, L., Villeneuve, L., Cadieux, J., Boyer, R., & Préville, M. (2013) · Sexologies · doi:10.1016/j.sexol.2013.03.006 · Cited by 7 · see citing works
Dargis, L., Trudel, G. A., Cadieux, J., Villeneuve, L., Préville, M., & Boyer, R. (2012) · Sexologies · doi:10.1016/j.sexol.2012.01.004 · Cited by 6 · see citing works
Durante, L., Bianco, M. D., Pelizzari, A., Mandato, F. G., Esposito, C., & Castagnetti, M. (2020) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2020.11.024 · Cited by 5 · see citing works
Villeda-Sandoval, C. I., Calao-Pérez, M. B., Herrera-Caceres, J. O., González-Cuenca, E., Rodríguez‐Covarrubias, F., & Castillejos-Molina, R. (2015) · Revista Mexicana de Urología · doi:10.1016/j.uromx.2015.06.009 · Cited by 5 · see citing works
Vie sexuelle des jeunes adultes opérés dans l’enfance d’un hypospadias postérieur
Even, L., Bouali, O., Moscovici, J., Huyghe, É., Pienkowski, C., Rischmann, P., Galinier, P., & Gamé, X. (2015) · The French Journal of Urology · doi:10.1016/j.purol.2015.04.006 · Cited by 4 · see citing works
Psychosocial, Sexual Function, and Fertility in Hypospadias
Jayasimha, S., & Chandrasingh, J. (2022) · Springer eBooks · doi:10.1007/978-981-16-8395-4_27 · Cited by 3 · see citing works
Meissner, V. H., Soehne, V. A., Dinkel, A., Jahnen, M., Schiele, S., Kron, M., Gschwend, J. E., & Herkommer, K. (2025) · International Journal of Impotence Research · doi:10.1038/s41443-025-01119-1 · Cited by 2 · see citing works
Lower urinary tract symptoms and sexual functioning in patients with depression
Przydacz, M., Gołąbek, T., Skalski, M., Sobański, J. A., Chorągwicki, D., Klasa, K., Pyrkosz, P., Dudek, D., & Chłosta, P. L. (2021) · Psychiatria Polska · doi:10.12740/pp/onlinefirst/131532 · Cited by 2 · see citing works
Modified calculation of the IIEF6—a more accurate assessment of erectile function in middle-aged men
Kirchhoff, F. P., Hübner, R. D., Kron, M., Schiele, S., Schulwitz, H. S., Peter, C., Meissner, V. H., Jahnen, M., Gschwend, J. E., & Herkommer, K. (2024) · The Journal of Sexual Medicine · doi:10.1093/jsxmed/qdae136 · Cited by 2 · see citing works
Prevalencia de disfunción eréctil en una muestra de población joven en México
González-Cuenca, E., Villeda-Sandoval, C. I., Zavaleta, M. S.-D., Ibarra-Saavedra, R., Calao-Pérez, M. B., Quijada-Carlton, H., Feria-Bernal, G., & Castillejos-Molina, R. (2012) · Revista Mexicana de Urología · Cited by 2 · see citing works
International Index of Erectile Function: A Misnomer at Risk of Being Misleading from Misuse
Chew, K.-K. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2011.02357.x · Cited by 2 · see citing works
Yule, M. A., Davison, B. J., & Brotto, L. A. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02053.x · Cited by 2 · see citing works
Endo, Y., Tanaka, T., Kojo, K., Matsumoto, C., Kurobe, M., Nishiyama, H., Takayama, T., & Miyazaki, J. (2026) · Healthcare · doi:10.3390/healthcare14060759 · Cited by 1 · see citing works
Mancheron, A., Dumas, A., Nion–Larmurier, I., Landman, C., Peyrin‐Biroulet, L., Caron, B., Baudry, C., Allez, M., Serrero, M., Yahioune, D., et al. (2024) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjae175 · Cited by 1 · see citing works
Un nuevo enfoque terapéutico para la disfunción eréctil: las ondas de choque de baja intensidad
del Valle, U., García‐Perdomo, H. A., Flórez, G. M. O., & Libre, U. (2015) · IATREIA · doi:10.17533/udea.iatreia.v28n3a06 · Cited by 1 · see citing works
Influence of myofascial therapy on painful erection – case study
Rogala, A., & Brzuszkiewicz-Kuźmicka, G. (2020) · Ból · doi:10.5604/01.3001.0014.6060
Sexual Dysfunction in Males Receiving Buprenorphine-naloxone-based Opioid Substitution Therapy
Ghosh, P., Gogoi, A., & Baidya, S. (2021) · Indian Journal of Private Psychiatry · doi:10.5005/jp-journals-10067-0074
Arvinder-Singh, H. S., Hamat, R. A., Durai, J. P., Kaur, H., Razlan, N. I., Lechmiannandan, S., Ho, C. C. K., & DEVESAHAYAM, P. R. (2026) · Sexual Medicine · doi:10.1093/sexmed/qfag009
Ketamine abuse also affects sexual health
Leerssen, E. C. M., van der Sanden, W. M. H., de Kemp, V. F., Schipper, R. A., Wyndaele, M., & de Kort, L. M. O. (2026) · Sexual Medicine · doi:10.1093/sexmed/qfag049
Lv, H., Chen, H., Xu, H., He, L., Wu, H., Yao, D., & Lu, C. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1890558
- Authors
- Rynja, S., Bosch, R., Kok, E., Wouters, G., & De Kort, L.
- Affiliations
- University Medical Center Utrecht (NL)
- Department of Urology, University Medical Center Utrecht , Utrecht , the Netherlands
- Canisius-Wilhelmina Ziekenhuis (NL)
- Corresponding author
- Rynja, Sybren
- ORCID
- Rynja, Sybren
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-08-01
- Volume
- 7
- Issue
- 8
- Pages
- 2825-2830
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W1545774657
- Cited by
- 46
- References
- 18
- Citations by year
- 2026: 4 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 2 · 2018: 5 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 5 · 2012: 5
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urological Disorders and Treatments
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Keywords
- erectile dysfunction, young men, IIEF-15, questionnaire scoring, prevalence, sexual activity, relationship status
- MeSH terms
- Adolescent, Adult, Age Factors, Health Surveys, Humans, Erectile Dysfunction, Libido, Male, Netherlands, Orgasm, Personal Satisfaction, Surveys and Questionnaires, Students, Medical, Benchmarking, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
