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sexual health inventory for men (SHIM): ED questionnaire

The sexual health inventory for men is an ED questionnaire for men to fill out on their own about the quality of their erections and how they feel about them. It is up to you whether to bring this to your doctor as part of your physical exam for erectile dysfunction.

Each question has several possible responses. Circle the number of the response that best describes your own situation. Please be sure that you select one and only one for each question.

OVER THE PAST 6 MONTHS:

1. How do you rate your confidence that you could get and keep an erection?

None
Very Low
Low
Low
Moderate
High
Very
High

         
0
1
2
3
4
5

 

 

 

2. When you had erections with sexual stimulation, how often were your erections hard enough for penetration (entering your partner)?

No sexual
activity
Almost
never or
never
A few times (much less than 1/2 the time)
Sometimes (about ½ the time)
Most times (much more than ½ the time)
Almost always or always

         
0
1
2
3
4
5

 

 

 

3. During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?

Did not attempt intercourse
Almost
never or
never
A few times (much less than 1/2 the time)
Sometimes (about ½ the time)
Most times (much more than ½ the time)
Almost always or always

         
0
1
2
3
4
5

 

 

 

4. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?

Did not attempt intercourse
Almost
never or
never
A few times (much less than 1/2 the time)
Sometimes (about ½ the time)
Most times (much more than ½ the time)
Almost always or always

         
0
1
2
3
4
5

 

 

  

5. When you attempted sexual intercourse, how often was it satisfactory for you?

Did not attempt intercourse
Almost
never or
never
A few times (much less than 1/2 the time)
Sometimes (about ½ the time)
Most times (much more than ½ the time)
Almost always or always

         
0
1
2
3
4
5

 

  

KEY

22-25 Normal erectile function
17-21 Mild ED
12-16 Mild to moderate ED
8-11 Moderate ED
< 7 Severe ED

 

 

 

 

 

  

Name: ___________________

 

Score: ___________________

Posted August 2008
Last Updated September 2009

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