SHIM, sexual health inventory for men

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 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