Questionnaire

1. Scale 1–10

(1 completely flaccid – 10 fully erect)

2. Can you achieve penetration? Select Yes No Sometimes 3. Do you climax? Select Yes No Sometimes How long does erection last? 6. Do you have a current partner? 7. Have you ever tried: 8. Other remedies? 9. Radiation therapy for prostate cancer? 10. Prostate surgery (TURP)? 11. Diabetes 12. Hypertension 13. Cholesterol 14. Do you use any of the following? Submit

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