MAMBA ED1000 · Performance assessment

Your sexual health. A clearer starting point.

A quick, private assessment to help start a clinical conversation.

Private. Personal. Clinical.

One conversation starts here.

Answer based on your experience over the past three months. This questionnaire is not a diagnosis or a validated IIEF-5 score. Your responses help the team understand your concerns.

Information submitted here is available to authorized clinical staff.

* Required fields

Your experience

Over the past 3 months, how often have you had difficulty achieving or maintaining an erection sufficient for intimacy? *

NeverOccasionallySometimesOftenAlmost always

Compared to previous years, how would you describe your erection firmness? *

Same as beforeSlightly weakerNoticeably weakerSignificantly weaker

How confident do you feel about your performance during intimacy? (1 = Very confident; 5 = Not confident at all) *

12345

Has this impacted your self-confidence or overall well-being? *

Not at allA littleModeratelyA great deal

Have these concerns caused you to avoid intimacy? *

NeverSometimesFrequentlyAlmost always

How often do you wake with morning erections? *

Almost dailyA few times per weekOccasionallyRarely or never

How often do you avoid intimacy due to erection concerns? *

NeverOccasionallyFrequently (I feel embarrassed)Almost always (due to performance anxiety)

During intercourse, how difficult do you find it to maintain your erection to completion? *

Extremely difficultDifficultSlightly difficultNot difficult

How would you describe the duration of your erections? *

Long enough for completionUsually adequateOften too shortRarely adequate

How satisfied do you think your partner is with your performance? *

Very satisfiedSomewhat satisfiedSomewhat dissatisfiedVery dissatisfied

Your contact details

Full name *

Email *

Phone number *

Preferred location *

Province or territory *

I confirm that I am 18 or older. I consent to MAMBA reviewing my responses and contacting me about this assessment. I understand this is not a diagnosis and does not guarantee treatment.

No payment is collected. Locations listed indicate your preference, not confirmed service availability.