Erection Hardness Score (Quick Check)

The Erection Hardness Score (EHS) is a validated single-question scale, published by Goldstein and colleagues in 2008, that grades erection firmness from 0 to 4. Grade 4 is completely hard and rigid; grade 3 is hard enough for penetration but not completely hard; grade 2 is hard but not enough for penetration; grade 1 is enlarged but not hard; and grade 0 is no change at all. It's a quick, plain way to describe an erection, widely used in research and clinics. It's a snapshot, not a diagnosis — but it's a useful shared language for talking with a clinician.

Grades 3 and 4 describe erections firm enough for satisfying sex — grade 4 fully rigid, grade 3 hard enough for penetration. Grades 0, 1, and 2 describe erections that aren't reliably firm enough for penetration, which is one of the hallmarks of erectile dysfunction. A single low grade isn't a diagnosis — erections vary with tiredness, stress, alcohol, and the situation — but a persistent grade of 2 or below is worth a conversation and often a fuller assessment. Think of the EHS as a fast first read, not a verdict.

The EHS is a single question about firmness — a 10-second snapshot. The IIEF-5 (also called the SHIM) is a five-question screen that looks at erectile function over the past six months, including confidence, how often erections are firm enough, and satisfaction, and it produces a score that grades the severity of any erectile dysfunction. The EHS is a great quick entry point; if it flags something, or if you want a fuller picture, the IIEF-5 is the natural next step. Many clinicians use both.

Often more than one thing at once. Physical causes are common and important — heart and blood-vessel disease, diabetes, high blood pressure, high cholesterol, low testosterone, certain medications, smoking, and being overweight all affect erections, and erectile difficulty can be an early warning sign of heart or vascular disease. Psychological factors like stress, anxiety, depression, and relationship strain also play a big part, and the two often combine. Because some causes are health conditions worth catching, a new or persistent problem deserves a check-up rather than just an online remedy.

Yes — erectile dysfunction is very treatable, and treatment often starts by addressing the underlying cause. Options include lifestyle changes (exercise, quitting smoking, managing blood pressure, cholesterol, and diabetes), oral medications, addressing low testosterone or medication side effects, psychological or couples support where anxiety or relationship factors are involved, and other medical treatments for more persistent cases. A clinician can match the approach to what's driving it — which is why getting evaluated, rather than self-treating, tends to work best.

Yes. This tool runs entirely in your browser. Your answer is graded on your own device and is never sent to a server, saved, or shared — close the tab and it's gone. It's general educational information based on a published, validated scale; it can't diagnose you or replace a conversation with a clinician.