Summary
Purpose and Primary Use:The Sexual Health Inventory for Men (SHIM), also known as the International Index of Erectile Function-5 (IIEF-5), is a validated, 5-item questionnaire designed for clinicians to assess the presence and severity of erectile dysfunction (ED) in men. It is intended to be a simple and effective diagnostic tool for use in clinical settings. Accurate diagnosis of ED is crucial as effective treatments are available, and ED can often be an indicator of underlying systemic diseases such as cardiovascular disease, diabetes, or neurological disorders. The SHIM is meant to complement, not replace, a comprehensive physical examination and patient history in the evaluation of ED. It can help reduce the number of incorrectly diagnosed or underdiagnosed cases of ED. Sources, References, and Literature:The SHIM questionnaire is an abridged and slightly modified version of the original 15-item International Index of Erectile Function (IIEF). Its development and validation as a diagnostic tool for erectile dysfunction are detailed in the following publication:Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM. Development of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11(6):319-326. doi:10.1038/sj.ijir.3900472. The SHIM focuses on key aspects of erectile function, including confidence, erection hardness, ability to maintain erection, and satisfaction with intercourse. Clinical Workflow and Parameters:The clinical workflow involves the patient completing the 5-item questionnaire. Each question addresses experiences over the last six months and offers five possible responses, scored from 1 to 5. The questions cover:Confidence in achieving and keeping an erection.Frequency of erections hard enough for penetration with sexual stimulation.Frequency of maintaining an erection after penetration.Difficulty in maintaining an erection to completion of intercourse.Frequency of satisfactory sexual attempts. The total SHIM score is the sum of the scores from these five questions, ranging from 5 to 25. The severity of ED is then classified based on the total score as follows:22 - 25: No significant erectile dysfunction17 - 21: Mild erectile dysfunction12 - 16: Mild-to-moderate erectile dysfunction8 - 11: Moderate erectile dysfunction5 - 7: Severe erectile dysfunction A score of 21 or less is generally considered indicative of ED that should be addressed. Related Decision Support Tools:The SHIM is derived from the more comprehensive International Index of Erectile Function (IIEF), a 15-item questionnaire that assesses multiple domains of male sexual function, including erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. While the SHIM provides a quick assessment of ED, the full IIEF may be used for a more detailed evaluation, particularly in research settings or complex clinical cases.