The International Index of Erectile Function (IIEF-5), also known as the Sexual Health Inventory for Men (SHIM), is the most widely used clinical tool for assessing erectile dysfunction. Developed by Dr. Raymond Rosen and colleagues, it has been validated in over 30 languages and is considered the gold standard by urological societies worldwide.
How the IIEF-5 Works
The questionnaire consists of 5 questions about erectile function over the past 6 months. Each question is scored from 1-5 (or 0-5 for questions about attempted intercourse), giving a total score range of 5-25.
Score Interpretation
22-25: No ED — Your erectile function is within normal range. This doesn't mean things can't improve further — preventive wellness measures like exercise, sleep optimization, and proper nutrition help maintain function long-term.
17-21: Mild ED — You may experience occasional difficulty achieving or maintaining full erections. This is often the most responsive stage to lifestyle interventions. Natural supplements, regular exercise, and stress management can frequently bring scores into the normal range.
12-16: Mild-to-Moderate ED — Erection difficulties are becoming more consistent. A combination of lifestyle changes and possibly supplements or low-dose medication is typically recommended. This is an important stage to intervene — addressing it now prevents progression.
8-11: Moderate ED — Significant difficulty with erections that is impacting sexual satisfaction. Medical consultation is recommended to identify underlying causes (vascular, hormonal, neurological). Treatment often involves medication alongside lifestyle optimization.
5-7: Severe ED — Persistent inability to achieve or maintain erections. This requires comprehensive medical evaluation, as it may indicate significant cardiovascular, neurological, or hormonal issues. Multiple treatment modalities are usually combined.
Important Context
Your IIEF-5 score is a snapshot, not a sentence. ED is often situational — stress, fatigue, alcohol, and relationship dynamics all influence scores. A single low score doesn't necessarily indicate a chronic problem. However, consistently low scores warrant investigation.
ED in men under 40 is more often psychogenic (anxiety, depression, porn-related) while in men over 50, vascular causes predominate. Understanding the cause guides the most effective treatment.