# Is there a test for ED? Questionnaires, blood tests, ultrasound and at-home kits explained

> There is no single test for erectile dysfunction. A clinician combines your history and an exam, often with a short scored questionnaire such as the IIEF-5, also called the SHIM. The American Urological Association recommends a morning testosterone level for men with ED, and ultrasound or nighttime erection tests only for some men.

_Last updated: 2026-10-17_

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**In short:** no blood test or scan gives a yes or no answer for erectile
dysfunction. ED is identified from what you report, and the tests exist to
measure how much it affects you and to look for what is behind it. The
American Urological Association (AUA) guideline recommends validated
questionnaires to gauge severity, a morning total testosterone level for men
with ED, and specialist tests such as ultrasound only for some men
([AUA Erectile Dysfunction Guideline]()).
This page explains each test by name, what at-home kits and online quizzes
can and cannot tell you, and when testing is worth a conversation with a
clinician. It is educational information, not medical advice.

## Is there a test for ED?

There is no single test that confirms ED on its own. Health care
professionals, including urologists, use your medical, sexual and mental
health history, a physical exam, and lab and other tests to diagnose it,
according to the National Institute of Diabetes and Digestive and Kidney
Diseases
([NIDDK, Diagnosis of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis)).
The AUA's first guideline statement says the same: a thorough history, a
physical exam and selective laboratory testing
([AUA Guideline, Statement 1]()).

So the "test" most men take first is a set of questions. The lab work and
scans that follow are mainly about cause: whether blood flow, hormones,
nerves, medicines or stress are playing a part. Our step-by-step guide to
[how ED is diagnosed](/how-ed-is-diagnosed) walks through the full
appointment, and if you are unsure whether you are at that point yet, our
guide on [when to see a doctor about ED](/when-to-see-a-doctor-about-ed)
covers the signs worth acting on.

## What are the names of the tests for erectile dysfunction?

The tests you are most likely to hear named fall into four groups:
questionnaires, blood tests, imaging, and erection tests. The table below
lists each one with what it measures and who usually gets it.

| Test name                                        | What it measures                                              | Who usually gets it                                   |
| ------------------------------------------------ | ------------------------------------------------------------- | ----------------------------------------------------- |
| IIEF-5, also called the SHIM                     | Presence and severity of ED, scored 5 to 25                   | Commonly used in clinics and research; self-completed |
| IIEF (full 15-item version)                      | Five areas of sexual function, including erections and desire | Mostly research and specialist settings               |
| Erection Hardness Score (EHS)                    | Hardness of erections on a single item                        | Clinics and trials, often to track treatment          |
| Morning total testosterone                       | Testosterone level in a morning blood sample                  | Recommended by the AUA for men with ED                |
| Blood sugar, lipids, thyroid and prostate tests  | Conditions linked to ED                                       | Chosen case by case                                   |
| Penile duplex ultrasound                         | Blood flow in the penis                                       | Some men, generally with complex histories            |
| Nocturnal penile tumescence and rigidity testing | Erections during sleep                                        | Some men, at home or in a sleep lab                   |
| Intracavernosal injection test                   | Whether the penis can respond with an erection                | In the office, for some men                           |

Sources for the table: the AUA guideline and its journal version
([AUA Guideline, J Urol 2018](https://www.auajournals.org/doi/10.1016/j.juro.2018.05.004)),
NIDDK
([NIDDK, Diagnosis of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis)),
and the questionnaire papers cited in the sections below.

## What are the IIEF-5 and SHIM questionnaires?

The IIEF-5 and the SHIM are the same short questionnaire: five questions
about erections and sexual satisfaction that you answer yourself. It was
developed as an abridged, five-item version of the 15-item International
Index of Erectile Function to diagnose the presence and severity of ED, and
its five items focus on erectile function and intercourse satisfaction
([Rosen et al., Int J Impot Res 1999](https://pubmed.ncbi.nlm.nih.gov/10637462/)).
Its developers have published under both names: IIEF-5 in the 1999
development paper and Sexual Health Inventory for Men in a 2005 review
([Rosen et al., 1999](https://pubmed.ncbi.nlm.nih.gov/10637462/);
[Cappelleri and Rosen, Int J Impot Res 2005](https://pubmed.ncbi.nlm.nih.gov/15875061/)).
The AUA notes the SHIM is sometimes called the IIEF-5 because it uses five
of the six questions in the full IIEF's erectile function section
([AUA Guideline, J Urol 2018](https://www.auajournals.org/doi/10.1016/j.juro.2018.05.004)).

Scores run from 5 to 25. In the development study of 1,152 men, a cutoff
of 21 separated men with and without ED best, and severity was split into
five levels from none to severe
([Rosen et al., 1999](https://pubmed.ncbi.nlm.nih.gov/10637462/)). A later
study using the IIEF-5 listed those bands as follows
([Rhoden et al., Int J Impot Res 2002](https://pubmed.ncbi.nlm.nih.gov/12152112/)):

| IIEF-5 score | Severity band    |
| ------------ | ---------------- |
| 22 to 25     | No ED            |
| 17 to 21     | Mild             |
| 12 to 16     | Mild to moderate |
| 8 to 11      | Moderate         |
| 5 to 7       | Severe           |

A 2005 review described the SHIM as widely used for screening and diagnosis
of ED and of its severity, in both clinical practice and research
([Cappelleri and Rosen, 2005](https://pubmed.ncbi.nlm.nih.gov/15875061/)).
The AUA names the SHIM, alongside the Erection Hardness Score, as an example
of a validated questionnaire, and notes that filling one in can be a way to
start the conversation about ED
([AUA Guideline, J Urol 2018](https://www.auajournals.org/doi/10.1016/j.juro.2018.05.004)).
A score describes how much trouble you are having. It does not say why.

## What does the full IIEF measure?

The full International Index of Erectile Function is a 15-item,
self-administered questionnaire that covers five areas of sexual function:
erectile function, orgasmic function, sexual desire, intercourse
satisfaction and overall satisfaction. Its 1997 validation paper reported it
was reliable, had been linguistically validated in 10 languages, and could
detect changes after treatment
([Rosen et al., Urology 1997](https://pubmed.ncbi.nlm.nih.gov/9187685/)).

That breadth is the point. Because it asks about desire and orgasm
separately from erections, it helps separate a change in interest from a
change in firmness. Its erectile function section is also the measure many
ED medicine trials report, which is why you see "IIEF-EF" scores in the AUA
guideline's treatment tables
([AUA Erectile Dysfunction Guideline]()).

## What is the Erection Hardness Score?

The Erection Hardness Score is a single question that rates how hard an
erection is. A 2007 validation study described it as a one-item,
patient-reported measure that was reliable, told apart men with normal and
impaired erectile function as defined by the IIEF, and responded strongly
to treatment
([Mulhall et al., J Sex Med 2007](https://pubmed.ncbi.nlm.nih.gov/17888069/)).

The study was built on data from a sildenafil trial, and its authors
supported the score mainly as a tool for clinical trials research. In
practice it is a quick way to put a number on one thing, hardness, and to
compare it before and after a change. Like the IIEF-5, it measures a
symptom, not its cause.

## Can you take an erectile dysfunction test online?

Yes, in the sense that many online ED quizzes ask questions like those on
the validated questionnaires, and the IIEF itself was designed to be
self-administered
([Rosen et al., 1997](https://pubmed.ncbi.nlm.nih.gov/9187685/)). What an
online quiz can give you is an estimate of how often and how badly
erections are a problem. That matches what the AUA says questionnaires are
for: assessing severity, measuring how well treatment works and guiding
later management
([AUA Guideline, Statement 2]()).

What a quiz cannot do is find the cause. The AUA guideline treats ED as a
risk marker for underlying cardiovascular disease and other conditions that
may warrant evaluation
([AUA Guideline, Statement 3]()),
and no set of answers on a screen replaces the exam and blood work that
look for those. A quiz score is a reasonable thing to bring to an
appointment. It is not a result to act on alone. Our guide to the
[symptoms of erectile dysfunction](/ed-symptoms) covers how to tell a
pattern from an off night.

## Is there an erectile dysfunction test at home?

There is no at-home kit that diagnoses ED, but some parts of testing can
happen at home. MedlinePlus says testosterone can sometimes be checked with
an at-home kit that collects a blood or saliva sample for a lab, and advises
talking to your provider first and following their instructions for
collecting and returning it
([MedlinePlus, Testosterone Levels Test](https://medlineplus.gov/lab-tests/testosterone-levels-test/)).
The same page adds that a testosterone result alone cannot diagnose any
health condition.

Nighttime erection testing can also happen at home. NIDDK says a nocturnal
erection test checks for erections during the night, can help show whether
ED is due to a physical problem, and may be done at home or in a sleep lab
([NIDDK, Diagnosis of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis)).
MedlinePlus lists a device worn at night as one option a provider may use
([MedlinePlus, Erection problems](https://medlineplus.gov/ency/article/007617.htm)),
and has an illustrated page on the nocturnal penile tumescence (NPT) stamp
test
([MedlinePlus, Erection self-test](https://medlineplus.gov/ency/imagepages/8894.htm)).
A 2020 perspective article described the RigiScan Plus device as the gold
standard for measuring nocturnal erections, while noting it is relatively
big and uncomfortable
([Edgar et al., Int J Impot Res 2020](https://pubmed.ncbi.nlm.nih.gov/33087873/)).
The AUA says specialized tests like this should only happen if the findings
will affect management, and should be done by an experienced examiner who
is familiar with interpreting the results. It also notes that having
nighttime or morning erections suggests, but does not confirm, a
psychological component, so they are worth mentioning at the visit rather
than treating as a verdict
([AUA Guideline, J Urol 2018](https://www.auajournals.org/doi/10.1016/j.juro.2018.05.004)).

Two general cautions apply to any home test. The FDA says home use tests
should not replace periodic visits to your doctor, and that most tests are
best evaluated together with your medical history, a physical exam and other
testing
([FDA, Home Use Tests](https://www.fda.gov/medical-devices/in-vitro-diagnostics/home-use-tests)).
MedlinePlus advises using only FDA-approved or FDA-authorized test kits and
following up with your provider whatever the result
([MedlinePlus, At-Home Medical Tests](https://medlineplus.gov/lab-tests/at-home-medical-tests/)).

## Which blood tests are used for ED?

The one blood test the AUA recommends for men with ED is a morning serum
total testosterone level
([AUA Guideline, Statement 4]()).
The guideline measures it to check for testosterone deficiency, which it
defines as total testosterone below 300 ng/dL together with symptoms and
signs, and it asks for at least two morning measurements before making that
diagnosis, so a low number by itself is not the diagnosis
([AUA Guideline, J Urol 2018](https://www.auajournals.org/doi/10.1016/j.juro.2018.05.004)).
Morning matters because, as MedlinePlus explains, the sample is usually
taken between 7 and 10 a.m., when testosterone levels are typically highest
([MedlinePlus, Testosterone Levels Test](https://medlineplus.gov/lab-tests/testosterone-levels-test/)).
Our page on [ED and low testosterone](/ed-and-low-testosterone) explains how
the two conditions overlap and differ.

Other blood tests are chosen case by case. The AUA says that, with the
possible exception of testosterone, blood sugar (glucose or hemoglobin A1c)
and, in some cases, blood fats (lipids), no routine blood test is likely to
change how ED is managed, though blood tests can still shed light on the
cause and reveal other conditions
([AUA Guideline, J Urol 2018](https://www.auajournals.org/doi/10.1016/j.juro.2018.05.004)).
NIDDK lists thyroid tests and prostate tests among the blood tests a
clinician may use to look for a cause
([NIDDK, Diagnosis of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis)),
and MedlinePlus adds that urine or blood tests can check for conditions such
as diabetes, heart problems or low testosterone
([MedlinePlus, Erection problems](https://medlineplus.gov/ency/article/007617.htm)).
Our guide to [hormones and ED](/hormones-and-ed) covers the thyroid side.

| Blood test                 | Why it may be ordered                                                        |
| -------------------------- | ---------------------------------------------------------------------------- |
| Morning total testosterone | Recommended by the AUA for men with ED, to check for testosterone deficiency |
| Glucose or hemoglobin A1c  | Blood sugar; one of the few routine tests the AUA says may change management |
| Lipids                     | Blood fats; flagged by the AUA as possibly useful in some cases              |
| Thyroid tests              | Listed by NIDDK as a possible test to find a cause                           |
| Prostate tests             | Listed by NIDDK as a possible test to find a cause                           |

Normal blood results do not rule out ED. They narrow down what is, and is
not, contributing.

## What is penile ultrasound?

Penile ultrasound is an imaging test that shows how blood flows through the
penis, which is how NIDDK describes its role in finding the cause of ED
([NIDDK, Diagnosis of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis)).
MedlinePlus likewise lists ultrasound of the penis to check for blood flow
problems among the tests a provider may use
([MedlinePlus, Erection problems](https://medlineplus.gov/ency/article/007617.htm)).

The AUA calls the version used for ED penile duplex ultrasound. It notes
that the scan may be combined with an intracavernosal injection, a medicine
injected into the penis in the office, to give a more detailed and
measured picture of how the penis's blood vessels respond
([AUA Guideline, J Urol 2018](https://www.auajournals.org/doi/10.1016/j.juro.2018.05.004)).
It is one of the specialized tests the AUA says may be needed for some men
with ED, generally those who present with complex histories, rather than a
routine first step
([AUA Guideline, Statement 5]()).
Other specialized tests the guideline discusses include nocturnal penile
tumescence and rigidity testing, the injection test on its own,
biothesiometry (a test of nerve sensitivity), cavernosometry and selective
internal pudendal angiography
([AUA Guideline, J Urol 2018](https://www.auajournals.org/doi/10.1016/j.juro.2018.05.004)).

## When should you talk to a clinician about testing?

Talk to a clinician when erection trouble keeps coming back. MedlinePlus
suggests seeing a provider if you have trouble getting or keeping an
erection more than 25% of the time, and contacting one if the problem began
after an injury or prostate surgery or comes with symptoms such as low back
pain, abdominal pain or a change in urination
([MedlinePlus, Erection problems](https://medlineplus.gov/ency/article/007617.htm)).

There is also a reason beyond the bedroom. The AUA says men should be told
that ED is a risk marker for underlying cardiovascular disease and other
health conditions that may warrant evaluation and treatment
([AUA Guideline, Statement 3]()).
A risk marker raises the odds of a condition; it is not a diagnosis of one.
Which tests make sense for you is a decision for a licensed clinician. Our
guide on [how to bring up ED with a doctor](/talking-to-a-doctor-about-ed)
covers what to say and what to bring, including any questionnaire score you
have already worked out.

## Sources

Every clinical statement on this page traces to a primary, guideline or
government source:

- Burnett AL, et al. Erectile Dysfunction: AUA Guideline. J Urol 2018;200:633. Questionnaire examples (Erection Hardness Score, Sexual Health Inventory for Men, also called the IIEF-5), the laboratory discussion (testosterone, glucose or hemoglobin A1c, lipids in some cases, the 300 ng/dL definition with symptoms and signs, at least two morning measurements), and the specialized tests, including duplex ultrasound combined with injection, who should perform them, and what nighttime or morning erections suggest: [auajournals.org, AUA ED guideline](https://www.auajournals.org/doi/10.1016/j.juro.2018.05.004)
- American Urological Association, Erectile Dysfunction (ED) Guideline (2018), web version. Guideline Statements 1 to 5 and the IIEF-EF treatment tables: [auanet.org, ED guideline]()
- NIDDK, Diagnosis of Erectile Dysfunction, last reviewed October 2024. History, exam, blood tests including thyroid and prostate tests, ultrasound of penile blood flow, the nocturnal erection test at home or in a sleep lab, and the injection test: [niddk.nih.gov, ED diagnosis](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis)
- Rosen RC, et al. The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997;49:822. Fifteen items, five domains, self-administered, validated in 10 languages, sensitive to treatment: [PubMed 9187685](https://pubmed.ncbi.nlm.nih.gov/9187685/)
- Rosen RC, et al. Development and evaluation of an abridged, 5-item version of the IIEF (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999;11:319. Five items, scores 5 to 25, cutoff of 21, five severity levels, 1,152 men: [PubMed 10637462](https://pubmed.ncbi.nlm.nih.gov/10637462/)
- Rhoden EL, et al. The use of the simplified IIEF-5 as a diagnostic tool to study the prevalence of erectile dysfunction. Int J Impot Res 2002;14:245. The five IIEF-5 severity bands: [PubMed 12152112](https://pubmed.ncbi.nlm.nih.gov/12152112/)
- Cappelleri JC, Rosen RC. The Sexual Health Inventory for Men (SHIM): a 5-year review of research and clinical experience. Int J Impot Res 2005;17:307. Use for screening and diagnosis of ED and its severity: [PubMed 15875061](https://pubmed.ncbi.nlm.nih.gov/15875061/)
- Mulhall JP, et al. Validation of the Erection Hardness Score. J Sex Med 2007;4:1626. A one-item, patient-reported hardness measure: [PubMed 17888069](https://pubmed.ncbi.nlm.nih.gov/17888069/)
- Edgar R, et al. New methods for the monitoring of nocturnal erections. Int J Impot Res 2022;34:1 (online 2020). Perspective article; RigiScan Plus as the gold standard for nocturnal erection measurement: [PubMed 33087873](https://pubmed.ncbi.nlm.nih.gov/33087873/)
- MedlinePlus, Erection problems, reviewed October 2025. The 25% guidance, when to contact a provider, and the tests a provider may use: [medlineplus.gov, erection problems](https://medlineplus.gov/ency/article/007617.htm)
- MedlinePlus, Erection self-test (NPT stamp test), reviewed October 2025: [medlineplus.gov, erection self-test](https://medlineplus.gov/ency/imagepages/8894.htm)
- MedlinePlus, Testosterone Levels Test. Morning sampling, at-home kits, and the limits of a single result: [medlineplus.gov, testosterone test](https://medlineplus.gov/lab-tests/testosterone-levels-test/)
- MedlinePlus, At-Home Medical Tests. FDA-approved or authorized kits and follow-up with a provider: [medlineplus.gov, at-home tests](https://medlineplus.gov/lab-tests/at-home-medical-tests/)
- U.S. Food and Drug Administration, Home Use Tests. Home tests do not replace visits and are best read with history, exam and other testing: [fda.gov, home use tests](https://www.fda.gov/medical-devices/in-vitro-diagnostics/home-use-tests)

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