Performance Enhancing Medication (PEM) Sexual and Fertility Risk Assessment Questionnaire

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Performance Enhancing Medication (PEM) Sexual and Fertility Risk Assessment Questionnaire

Creating a comprehensive risk assessment questionnaire for individuals using performance-enhancing medications (PEMs) involves evaluating potential risks to sexual and fertility health. Here’s a structured approach with self-scoring and risk grading:

Performance Enhancing Medication (PEM) Sexual and Fertility Risk Assessment Questionnaire

Performance Enhancing Medication (PEM) Sexual and Fertility Risk Assessment Questionnaire

General Information

1. Which performance-enhancing medications are you currently using or have used in the past? (Check all that apply)
2. How long have you been using performance-enhancing medications?
3. Have you consulted a healthcare provider before starting PEMs?

Sexual Function and Performance

1. Have you noticed any changes in sexual function since starting PEMs?

Fertility Concerns

1. Have you experienced any fertility issues since starting PEMs?
3. Have you undergone any fertility testing or evaluation since starting PEMs?

Medical Follow-Up

1. Have you discussed sexual or fertility concerns related to PEMs with a healthcare provider?

Scoring Instructions:

Scoring and Risk Grading

Calculate the scores based on the responses to each section:

– *PEM Usage Duration Score:* Response from question 2 (range: 0-3)
– *Sexual Function Changes Score:* Sum responses to questions 4 and 6 (range: 0-10)
– *Fertility Issues Score:* Response from question 7 (0 or 1)
– *Medical Follow-Up Score:* Response from question 11 (0 or 1)

 Risk Grading

Based on the total scores, assess the risk level associated with PEM usage:

Total Score Interpretation:
– 0-3: Low risk
– 4-7: Moderate risk
– 8-10: High risk

NOTE – This questionnaire is a tool to help assess sexual and fertility health risks associated with performance-enhancing medications. Please discuss your responses with your healthcare provider to ensure appropriate evaluation and treatment based on your risk grading and scores. Adjustments can be made to better suit specific concerns or clinical settings as needed.

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