IIEF-5 Erectile Function Self-Assessment

Clinical Tool — Dr. Muhammad Khalid

IIEF-5 Erectile Function Self-Assessment

The IIEF-5 erectile function self-assessment — also known as the SHIM questionnaire — is the most widely used validated screening tool for erectile dysfunction in urology clinics worldwide. Answer five straightforward questions about your sexual function over the past four weeks and receive your clinical severity score, a domain-by-domain breakdown, and a personalized action plan based on the same framework used in specialist urological practice. If your score falls in the moderate or severe range, this tool will also flag whether vascular screening is recommended — because in men under 50, undiagnosed ED is frequently the earliest detectable warning sign of cardiovascular disease.

This tool is an evidence-based clinical aid developed by a specialist urologist. It is a conversation starter with your doctor, not a diagnostic substitute.

Over the past 4 weeks — answer honestly for the most accurate result

Q1: How confident were you that you could get and keep an erection?

Very low

Low

Moderate

High

Very high

Q2: When you had erections with sexual stimulation, how often were they 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)

Almost always / always

Q3: During intercourse, how often could you maintain your erection after penetration?

Almost never / never

A few times (much less than half the time)

Sometimes (about half the time)

Most times (much more than half)

Almost always / always

If you did not attempt intercourse in the past 4 weeks, select the option that best describes what you would expect.

Q4: During intercourse, how difficult was it to maintain your erection to completion?

Extremely difficult

Very difficult

Difficult

Slightly difficult

Not difficult

Q5: When you attempted 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)

Almost always / always

IIEF-5 Score

— /25

—

Your Personalized Action Plan

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Frequently Asked Questions About the IIEF-5 Questionnaire

What is the IIEF-5 erectile function self-assessment?

The IIEF-5 (International Index of Erectile Function, 5-item version) is a shortened, validated form of the full 15-question IIEF, developed by Rosen et al. in 1999. It is the most widely used screening tool for erectile dysfunction in urology clinics and clinical trials worldwide. A score of 21 or below suggests some degree of ED. Learn more in our ED treatment guide.

What IIEF-5 score is considered normal?

A score of 22 to 25 indicates normal erectile function. Scores of 17 to 21 suggest mild ED; 12 to 16 mild-to-moderate; 8 to 11 moderate; and 5 to 7 severe ED. These thresholds come directly from the original Rosen validation study and are the same cutoffs used in urological practice and clinical research worldwide.

Can ED be an early sign of heart disease?

Yes. The penile arteries are 1 to 2 mm in diameter — roughly half the size of coronary arteries. Atherosclerotic plaque narrows them first, which is why ED precedes a cardiac event by an average of 3 to 5 years in multiple studies. Any man under 50 with new-onset ED and no obvious cause should have cardiovascular risk factors formally assessed. Read more in our ED and heart disease guide.

Should I bring my IIEF-5 score to my doctor?

Yes. Printing or screenshotting your result gives your primary care doctor or urologist an objective baseline to compare against future assessments. It also opens a structured conversation — many men find it easier to present a score than to describe symptoms verbally. Your doctor can then order the relevant blood tests: testosterone, fasting glucose, and a lipid profile. See our 40+ health checklist for the full recommended panel.

Is the IIEF-5 the same as the SHIM questionnaire?

Yes. The Sexual Health Inventory for Men (SHIM) is simply an alternative name for the IIEF-5. They are identical — five questions, same scoring, same severity bands. Both names are used interchangeably in clinical practice and research literature.

Dr. Muhammad Khalid

MBBS · FCPS (Urology) · MCPS (Gen. Surgery) · CHPE · CRSM · IMC #539472

Specialist urologist with 11+ years of clinical experience across tertiary teaching hospitals. Trained at Lady Reading Hospital and Khyber Teaching Hospital, Peshawar. Author of 5 peer-reviewed international publications in Cureus, WJSA, and AJBS. Procedural expertise: URS, PCNL, RIRS, TURP, TURBT, and major open urological surgery. Full profile →

This article is for educational purposes only and does not constitute medical advice. Always consult your physician or urologist for diagnosis and treatment decisions specific to your condition.