Erectile dysfunction: Proposed definition and staging for early diagnosis

Table 1 Clinical staging of erectile dysfunction and classification

Stages of ED	Description	Classification of ED	Sexual performance
ED0	Normal rigidity, able to penetrate normally	Normal	Normal
ED1	Reduced rigidity, able to penetrate normally	Early ED	Not interfering with sexual performance
ED2	Reduced rigidity, able to penetrate with difficulty, always	Mild ED	May or may not interfere with sexual performance
ED3	Reduced rigidity, able to penetrate with difficulty, most of the time
ED4	Reduced rigidity, able to penetrate with difficulty, rarely	Moderate ED	Interfering with sexual performance
ED5	Markedly reduced rigidity, unable to penetrate	Severe ED	Unable to perform penetrative sexual activity
ED6	Flaccid, unable to penetrate
ED7	Completely flaccid, unable to penetrate

ED: Erectile dysfunction.

Table 2 Classification of erectile dysfunction

Clinical classification of ED
Depending upon the duration of the ED
Transient ED
Persistent ED
Depending upon the frequency of ED
Intermittent ED
Consistent ED
Depending upon the etiology of ED
Psychogenic ED
Organic ED
Vascular ED
Arteriogenic
Cavernosal (Venogenic)
Mixed
Endocrine ED
Anatomic ED
Neurologic ED
Iatrogenic ED
Combined ED
Depending upon the circumstances of the ED
Situational ED
Partner-related ED
Performance-related ED
Psychological distress- or adjustment-related ED
Global ED
Depending upon the course of the ED
Acute ED (Sudden onset ED)
Chronic ED (Indolent ED or gradually progressive ED)
Depending upon the associated health issues
Primary ED or idiopathic ED
Secondary ED
Depending upon association with another sexual dysfunction
Isolated ED (Simple ED)
Complicated ED (ED associated with another sexual dysfunction)
Primary ED with another sexual dysfunction
ED secondary to another sexual dysfunction
Depending upon dysfunction in the steps of erection
ED with initiation problem
ED with a maintenance problem
Depending upon the onset of ED
Lifelong ED
Acquired ED
Depending upon the domain of dysfunction
Decreased quality of erection
Decreased frequency of erection
Decreased durability of erection
Increased threshold for erection
Depending upon the type of sexual activity
ED associated with peno-vaginal intercourse
ED associated with peno-anal intercourse
ED associated with peno-oral intercourse
ED associated with self-sex (masturbation)
Depending upon the presence of symptoms
Asymptomatic ED
Symptomatic ED
Depending upon the severity of the ED
Early ED
Mild ED
Moderate ED
Severe ED
Depending upon the neurovascular mechanism of the erectile process
Failure to initiate (neurogenic)
Failure to fill (arterial)
Failure to store (venous)

ED: Erectile dysfunction.