This questionnaire has been developed to analyze the possible presence of a premature ejaculation (too fast ) during sexual intercourse . Premature ejaculation is the most common male sexual dysfunction .

The questionnaire consists of 5 multiple choice questions . For each question it is necessary to specify an unique answer. Typically , the characteristics of your ejaculation may change from time to time . For this questionnaire please will give answers indicative of your most common situation . For this questionnaire we consider ejaculation occurred after vaginal penetration .

The questionnaire does not replace in any way the medical examination which remains the essential tool for the evaluation of patients with premature ejaculation.


Ejaculation refers to the release of semen after penetration

(i.e. when your penis enters your partner)

Not difficult at all Somewhat difficult Moderately difficult Very difficult Extremely difficult
1. How difficult is it for you to delay ejaculation? 0 1 2 3 4
Never or almost never (0%) Less than half the time (25%) About half the time (50%) Over half the time (75%) Always or almost always (100%)
2. Do you ejaculate before you want to? 0 1 2 3 4
3. Do you ejaculate with very little stimulation? 0 1 2 3 4
Not at all Slightly Moderately Very Extremely
4. Do you feel frustrated because of ejaculating before you want to? 0 1 2 3 4
5. How concerned are you that your time to ejaculation leaves your partner unfulfilled? 0 1 2 3 4