Sexual Health Inventory for Men (SHIM) score
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International Index of Erectile Function (IIEF-5)
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Background Info : [Total score + assessment provided].
The purpose of this tool is to automate the scoring of 'The International
Index of Erectile Function (IIEF) (also known as the SHIM Questionnaire)'. This
program will determine the total score from the corresponding questions below
and provide an assessment of erectile function. Sexual health which
is defined as the state of physical, emotional, mental and social well-being in
relation to sexuality, is an important contributor to in an individual's
well-being. Fortunately, several treatment options are available to
address erectile dysfunction (ED). A total score below 21 indicates at
least some degree of ED.
A final summary will be provided after the form is submitted:
1. Baseline ED severity (none or mild, moderate, severe)
2. Confidence in getting and maintaining erection
Note: This tool can also be used to assess the effectiveness of a particular
treatment option and whether or not additional interventions are required.
It is intended to complement the physical examination and patient history as a
means to detect ED.
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Instructions
Review each question and select the
response that best describes your own situation OVER THE PAST 6 MONTHS:
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1. How do you rate your confidence that you could get and
keep an erection?
Very low
Low
Moderate
High
Very high
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2. When you had erections with sexual stimulation, how often
were your erections hard enough for penetration?
Almost never/never
A few times (much less than half the time)
Sometimes (about half the time)
Most times (much more than half the time)
Almost always/always
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3. During sexual intercourse, how often were you
able to maintain your erection after you had penetrated (entered)
your partner?
Almost never/never
A few times (much less than
half the time)
Sometimes (about half the time)
Most times (much more than half
the time)
Almost always/always
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4. During sexual intercourse, how difficult was it
to maintain your erection to completion of intercourse?
Extremely difficult
Very difficult
Difficult
Slightly difficult
Not difficult
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5. When you attempted sexual intercourse, how often
was it satisfactory for you?
Almost never/never
A few times (much less than
half the time)
Sometimes (about half the time)
Most times (much more than half
the time)
Almost always/always
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References
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- Rosen RC, Cappelleri JC, Smith MD, et al. Development and evaluation
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 Dec;11(6):319-26.
- Tsertsvadze A, Yazdi F, Fink HA, et al. Diagnosis and Treatment of
Erectile Dysfunction. Evidence Reports/Technology Assessments, No. 171.
Rockville (MD): Agency for Healthcare Research and Quality (US); 2009
May.
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