The Erection Hardness Scale (EHS), an easy-to-use, four-point scale for erectile dysfunction (ED), provides a reliable measure of erection hardness and an indicator of other health and wellbeing outcomes, according to new data reported at the European Association of Urology.

EHS rates the hardness of erection on a scale of one to four, with four being the maximal score. The language used is simple and direct, so that men with ED can use the scale to assess the severity of their condition and to monitor the impact of treatment. A score of 1 indicates that the penis is larger than normal, but not hard; 2 means the penis is hard, but not hard enough for penetration, 3 means the penis is hard enough for penetration but not completely hard, and 4 indicates that the penis is completely hard and fully rigid.

A new study, SCORE 4 (Scoring Correspondence in Outcomes Related Erectile Dysfunction Treatment on a 4-point Scale), compared ratings on the Erection Hardness Scale with other scales commonly used in clinical trials of ED, including the International Index of Erectile Function (IIEF). It included 209 men (mean age 52 years) diagnosed with ED who were randomised to sildenafil or placebo, followed by an open-label extension period with flexible-dose sildenafil (50mg or 100mg).

The results showed a nearly linear relationship between EHS ratings and results from other scoring systems. The relationship between the discrete points of the EHS and scores on components of other rating scales, including the IIEF, showed the close correspondence between erection hardness and erectile function, satisfaction with the quality of an erection, the overall sexual experience and emotional well-being in men with ED.

Commenting on the clinical implications of the findings, Professor Herman van Ahlen, Professor of Urology, Klinikum Osnabruck, Muenster University, Germany, said: “These data validate the importance of measuring erection hardness because of its link to other factors.”

Professor van Ahlen said that the Erection Hardness Scale provided a simple, effective tool that could be used in clinical practice for assessing patients with ED. He added: “The EHS measures more than just erection hardness. It can also provide an assessment of the other factors associated with this debilitating condition. A patient’s satisfaction with erection hardness has the scope to predict satisfaction with other quality of life measures.”

European Association of Urology.

Written by – Susan Mayor