Good on you for taking the first step. Erectile dysfunction can be treatable and these simple 7 questions can help you discover who can help you find a solution. It might even be as simple as visiting your pharmacist. There are no wrong answers and everything is strictly confidential.
By completing this questionnaire, you acknowledge that the purpose of this is to support your discussion with a healthcare professional about erectile dysfunction. It is intended for general guidance only and does not replace personalised medical advice from a pharmacist, General Practitioner, or other qualified healthcare provider. Your responses are private and are not collected, stored, viewed, or accessed by us. No identifiable personal information is captured or retained. By proceeding, you confirm that you understand this information and consent to continue.

LET’S GET STARTED

1.
Do you have difficulty getting or maintaining an erection (erectile dysfunction)?
2.
Have you discussed these symptoms with your doctor?
3.
Have you taken medications for erectile dysfunction before?
4.
Are you aged between 35 to 70 years old (inclusive)?
5.
Do you have any of the following medical conditions:
  • cardiovascular/heart conditions,
  • diabetes,
  • severe liver/kidney conditions,
  • serious eye conditions,
  • or any other medical conditions?
6.
Are you currently a smoker?
7.
Do you take any medicines, particularly any of the following:
  • high blood pressure medicines (two or more),
  • nitrates for chest pain,
  • medicines for pulmonary arterial hypertension,
  • antiviral medicines to treat human immunodeficiency virus (HIV),
  • erectile dysfunction medicines,
  • alpha-blockers (medicines to treat prostate/urinary conditions or high blood pressure),
  • recreational drugs