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Also known as
IIEF-5, 5-item International Index of Erectile Function, Sexual Health Inventory for Men Questionnaire, SHIM Questionnaire
Definition
The Sexual Health Inventory for Men (SHIM) is a validated, abridged 5-item version of the 15-item International Index of Erectile Function (IIEF) designed as a diagnostic tool for erectile dysfunction (ED).1 Developed in 1999 by Rosen et al., this brief questionnaire evaluates erectile function and intercourse satisfaction over the past six months through five specific questions, each with five possible responses scored from 1 to 5.2 The SHIM focuses on a patient’s confidence in maintaining erections, erection hardness, ability to maintain erections after penetration, difficulty maintaining erections throughout intercourse, and overall satisfaction with sexual intercourse.1 With a total score ranging from 5 to 25, the SHIM categorizes erectile dysfunction severity into five levels: severe (5-7), moderate (8-11), mild-to-moderate (12-16), mild (17-21), and no ED (22-25).2 This tool serves as an efficient screening method in clinical settings, particularly valuable for identifying ED in patients presenting with other urological conditions.3
Clinical Context
The SHIM is widely used in urology clinics to evaluate and assess treatment efficacy for erectile dysfunction.2 It serves as an efficient screening tool for ED in patients presenting with other urological complaints, with maximum benefit observed in patients between 51 and 70 years of age and in those with diabetes mellitus.2 The questionnaire is administered to patients who are typically 40 years of age or older, as ED affects approximately 20% of men in this age group, with risk increasing with age and comorbidities.2
The SHIM’s clinical utility extends beyond initial diagnosis to monitoring treatment response. With the advent of oral therapies for ED, the need for accurate diagnosis has become increasingly important.3 The tool complements physical examination and patient history in diagnosing the presence and severity of ED, potentially reducing the number of incorrectly diagnosed or underdiagnosed cases.3
Patient selection for SHIM screening typically includes men over 40 years presenting with urological complaints, though it may be administered to younger patients with risk factors for ED. The questionnaire is self-administered, requiring approximately 5 minutes to complete, making it practical for busy clinical settings.1 A score of 21 or less indicates that erectile dysfunction should be addressed, with lower scores correlating with increasing ED severity.3