Sexual Health Inventory For Men (SHIM)
[Pages:2]Sexual Health Inventory For Men (SHIM)
Instructions
Each question has 5 possible responses. Circle the number that best describes your own situation. Select only 1 answer for each question.
Over the past 6 months:
1. How do you rate your confidence that you could keep an erection?
1 Very low
2
3
4
Low
Moderate
High
5 Very high
2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration (entering your partner)?
1
Almost never or never
2
A few times (much less than
half the time)
3
Sometimes (about half the time)
4
Most times (much more than
half the time)
5
Almost always or always
3. During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?
1
Almost never or never
2
A few times (much less than
half the time)
3
Sometimes (about half the time)
4
Most times (much more than
half the time)
5
Almost always or always
4. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
1 Extremely difficult
2 Very difficult
3 Difficult
4 Slightly difficult
5 Not difficult
5. When you attempted sexual intercourse, how often was it satisfactory for you?
1
Almost never or never
2
A few times (much less than
half the time)
3
Sometimes (about half the time)
4
Most times (much more than
half the time)
5
Almost always or always
Adapted with permission from: Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pe?a BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Dysfunction (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319-326. .
Information for Clinicians
Scoring instructions
Add the numbers corresponding to the answers for questions 1 through 5. If the patient's score is 21 or less, erectile dysfunction (ED) should be addressed. The SHIM score characterizes the severity of the patient's ED in the following manner:
22-25 No ED 17-21 Mild ED 12-16 Mild-to-moderate ED 8-11 Moderate ED 5-7 Severe ED
Score: ___________
Purpose of SHIM
? With the advent of oral therapies for ED, the need for accurate diagnosis is greater than ever. ? The SHIM Questionnaire (also known as the IIEF-5) is an abridged and slightly modified 5-item
version of the 15-item International Index of Erectile Function (IIEF), designed for easy use, by clinicians, to diagnose the presence and severity of ED in clinical settings. ? This diagnostic tool may reduce the number of incorrectly diagnosed or underdiagnosed cases. It is intended to complement the physical examination and patient history as a means to detect ED.
Adapted with permission from: Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pe?a BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Dysfunction (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319-326. .
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