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Erection Hardness Score (EHS): What's Your Score?

Erection Hardness Score (EHS): What's Your Score?

Harder is better, right? If we’re being honest with ourselves, a harder erection is always better than a soft one when it comes to sex. But how hard should your erection be for penetration? And how can you improve the hardness of your erection?

Erection hardness is the ability for your penis to stiffen and remain firm during sexual stimulation. And an ideal erection is one that remains firm enough for penetration and one that can last for the full duration of intercourse.

In general, the firmer your erection, the better it will feel for both you and your partner. A softer erection can feel more frustrating than pleasurable.

Which is why improving your ability to achieve a harder erection can not only make sex more enjoyable but it will also improve your confidence in the bedroom. With that being said, you can find out just how hard your erections are by utilizing the erection hardness score (EHS).

Here is everything you need to know about how to find out your erection score and ways to improve it if you are on the low end of the scoring (AKA, softer not harder).

infographic on erections calling you

What is the Erection Hardness Score (EHS) tool?

The erection hardness score tool, or rather, an assessment questionnaire was created in 1998 when doing clinical trials for diagnosing ED and comparing scores from placebo groups to intervention groups that took a treatment to improve blood flow (PED5i, sildenafil, Viagra, etc.).

Since then it has been used in investigational research for other treatments for erectile dysfunction, such as trimix (injections), and even Li-ESWT (shockwave therapy).

This question is a single item likert scale which rates your erection hardness. The question used is “How would you rate the hardness of your erection?” and then you would select from 5 options.

Just so you know, this one single question is not a substitute or diagnosis for ED as there are other factors to consider.

BUT, this tool or assessment is usually given to men alongside other questionnaire forms like the IIEF scoring tool (Much more comprehensive).

Usually men can fill out these forms or just use this assessment question for educational purposes. But, I’m sure most of you have probably seen the question above or have filled out an IIEF questionnaire form or additional forms at your doctors office when visiting a Urologist or participating in a clinical study.

erection hardness score infographic

How Do You Rate Your Erections Using The Erection Hardness Score?

To rate your erections using the Erection Hardness Score tool, you simply need to select one of the five options given in response to the question “How would you rate the hardness of your erection?”

  • 0 - Penis does not enlarge

  • 1 - Penis is larger, but not hard

  • 2 - Penis is hard, but not hard enough for penetration

  • 3 - Penis is hard enough for penetration, but not completely hard

  • 4 - Penis is completely hard and fully rigid

Some researchers exclude the 0 option whereas others use the full scale when doing the assessment.

But, this question is subjective and does have disadvantages such as patient-to-patient variability. Some men may have a higher threshold for what they consider to be hard enough for penetration, while others may have a lower threshold.

So, it’s important to keep in mind that the Erection Hardness Score is not a definitive measure of your erectile function, but rather an informative tool that can help you track and improve your erection quality.

Does Erection Hardness Decrease With Age?

The short answer is, Yes.

Although "age" is not a direct cause, the result of NOT taking care of your erections when you are younger, will only make it harder for you when you get older.
younger and older man in age comparison

When we age, we are more susceptible to health issues such as diabetes, cardiovascular disease, and other issues from poor lifestyle choices. These issues affect blood flow to the penis.

It's a no brainer.

If you're 50 years old and are questioning why your erections are not as stiff as they were in your 20s, then it's time to either take a look at the lifestyle you are currently living, evaluate if that's considered healthy for you.

Or go to a doctor if you have not done so already to make sure you've not developed a health condition that is impairing blood flow to your penis.

Your doctor might even ask you the erection hardness question along with others to assess where you're at in the bedroom.

The most important thing is to take action and work towards improving your erection quality. Understanding the erection process, body awareness and taking steps towards a healthier lifestyle can make all the difference in having harder, more satisfying erections regardless of your age.

The Advantages & Disadvantages Of The Erection Hardness Score Assessment

Being that this is a single question, the EHS tool is good for being a “quick” question to answer and for men to report back to their clinicians about their erection hardness.

However, the disadvantages are that it’s not as comprehensive or conclusive for a diagnosis of ED.

It’s hard to see the bigger picture with just this one question as there are other facets that affect a man's ability to get hard and stay hard.

infographic on The Advantages & Disadvantages Of The Erection Hardness Score Assessment

For instance, the long form questionnaire called the IIEF which stands for International Index Of Erectile Function contains 15 questions that covers these 5 domains:

  1. Erectile function

  2. Orgasmic function

  3. Sexual desire

  4. Intercourse satisfaction

  5. Overall satisfaction

Researchers and doctors prefer using the IIEF score for ED as it is more comprehensive. This doesn’t mean they don’t use the EHS score. They include it, but they use the additional long form questionnaires to help get a snapshot of the patients quality of life, physical concerns and the 5 domains we just mentioned that are in the IIEF form.

What is The IIEF Questionnaire For Erectile Dysfunction

What Happens If You Have A Low Erection Hardness Score?

Most researchers, especially the ones who studied Li-ESWT on men with erectile dysfunction and other sexual health related issues, viewed an erection hardness score of a 3 and a 4 as a the target goal for success when doing a before and after.

Since an erection score of a 3 is the threshold of being hard enough for penetration, but not completely hard, that’s something to think about, or aim for, when making goals of improving your hardness score.

man dealing with erectile dysfunction after taking a ehs score for erection hardness

For instance, if you are starting to notice a decline in your erections, and have been told by your doctor that you have some health threats (borderline high cholesterol, borderline diabetic, etc.), or there are concerns of weight issues or dieting, etc. then certain modifications to your lifestyle may improve blood flow if you start this management right away.

We’re not talking about pills or supplements, but lifestyle management. You want to get ahead of these health issues when they are “borders” and not full blown because this can only add more stress which is a major cause of poor erections.

How To Improve Your Erection Hardness Score

Always aim to improve your lifestyle choices as not only can it help your erections, but it can delay the development of the more serious diseases (diabetes, heart disease, high blood pressure, etc.).

Here are some simple lifestyle modifications to think about to get your health back on track:

  • Exercise or being active (play sports, go to the gym, take daily walks)

  • Enhanced diet that is heart healthy (bad heart health can lead to ED)

  • Therapy (for performance anxiety, and other negative learnings of sex when you were younger)

  • More quality sleep (7-9 hours suggested)

  • Drinking water/hydration (yes, this even affects your erections)

  • Cutting out sugar and processed foods (sugar and junk foods affect your erections)

  • Get regular check ups (blood pressure, blood work, etc.)

  • Avoid alcohol (not all together, but drinking excessively)

  • Stop smoking (smoking decreases blood flow and raises risk for ED)

  • Etc.

rich explaining that lifestyle choices effect your erections to a man dealing with ed

Make "Erection Hardness" Your Goal

Hypothetically speaking, let's pretend you have a low erection score of a 1 or a 2.

Maybe you experience this "decline" everyday or when you are intimate with your partner. If so, then treatment intervention will help as well.

You might have to use PED5i (Cialis/Viagra, etc.) in combination with lifestyle modifications to get you on track to get to a score of 3 or maybe 4.

You might also be considered a candidate for Li-ESWT or shockwave therapy for the physiological benefits of angiogenesis and other growth factors to help improve blood flow at a multi-strategic approach to improving your sexual performance.

The point is, make a goal to improve your scores and take this point in your life as a wakeup call, to get your sex life back on track.

Don't think "I'm too young for this...." because it can happen at any age.

Think of the erection score as a tool to help you keep on track with your overall sexual health.

rich helping train a man overcome his erectile dysfunction

Final Thoughts On EHS And Erections

Is the erection hardness score self assessment tool a substitute or a diagnosis of ED?


But, it’s a good general assessment to see where you are at and it’s good for being self aware of your own body and penis when it comes to your erection. 

You don’t necessarily have to answer this question in a doctor setting either. You can answer it on your own for educational purposes or use it to check in on where you’re at. If let’s say you decided to go to your doctor with a script for Viagra and it’s your first time taking these pills. Then you can rate the hardness of your erection before and after to see where you’re at and then you can report back to your doctor about dosing and if it's working for you.

The same can be said about shockwave therapy. Usually, they’ll give you the IIEF form to fill out as well as this is way more comprehensive than the EHS tool, but when you follow up, not only can you tell them your experience of before and after, you’ll be more aware of your own erections in relation to your overall health and lifestyle.

The point is, it’s about making these assessments so you can take control of your sexual health. You’ll be more knowledgeable and more empowered to have a better understanding of what your doctor is talking about and how things work.

Keep in mind, the EHS score can also make you aware of other issues that are related such as performance anxiety.

It’s also good at making you feel accountable in taking care of your sexual health.


Disclaimer: We are not doctors or medical professionals. We're not hear to diagnose or provide professional/medical advice. We're just here to share some research and personal experience. Always consult with a healthcare professional for any specific concerns or questions about your sexual health.

We hope this guide has provided you with valuable information on the Erection Hardness Score and how it can be used as a tool for self-awareness and understanding of your own body.

It's important to remember that the Erection Hardness Score is not a substitute for a medical diagnosis of erectile dysfunction. However, it can be a helpful tool in assessing your own sexual health and keeping track of any changes or improvements.

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