Male Sexual Health Questionnaire (MSHQ)

IIEF (15 items) focuses on erectile function and sexual satisfaction with emphasis on erection; MSHQ (~25 items) is broader, including erectile function, ejaculatory function, desire, and satisfaction. IIEF is the most validated single-domain erectile function measure; MSHQ provides more comprehensive sexual health assessment. Many clinicians use both for detailed evaluation.

The MSHQ erectile function subscale score <20 suggests moderate-to-severe erectile dysfunction; 20–25 indicates normal function. However, clinical interpretation should consider patient bother and baseline function. A man with score 22 who previously had score 28 may perceive decline and desire treatment; another with score 18 who is satisfied may decline therapy.

MSHQ-EjD includes items assessing ejaculatory control and satisfaction, providing useful information about ejaculatory function. However, formal diagnosis of premature ejaculation per DSM-5 requires clinical history (short duration of intravaginal ejaculation latency time, IELT <1 minute, accompanied by distress). MSHQ scores support but do not replace clinical interview.

MSHQ is moderately sensitive to phosphodiesterase-5 inhibitor therapy, with mean improvements in erectile function subscale of 5–12 points depending on baseline severity. Response varies individually; 60–80% of men show clinically meaningful improvement. MSHQ is suitable for pre/post-therapy comparison but less sensitive to dose effects than more detailed erectile function questionnaires.

Yes, MSHQ has been validated in older men. However, normative interpretation should account for age-related physiologic changes; slower arousal time, longer latency to ejaculation, and less firm erections are age-typical and may not warrant intervention if the man is satisfied. Clinical judgment integrating MSHQ score with patient age, sexual goals, and satisfaction is essential.