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SHIM Score & Prostate Cancer

The SHIM, or sexual health inventory for men, score is widely used in clinical practice and research to assess erectile dysfunction (ED), or impotence in men. Erectile dysfunction is loss of the ability to sustain an erection for intercourse. The severity of ED according to a SHIM score is from 1 to 25, with 1 being the most severe and 25 being healthy. Men with a SHIM score of 21 or under are generally told to seek medical advice to find out the cause of their ED. Prostate cancer is not necessarily a cause of ED, but treatments for prostate cancer can lead to ED.

  1. Surgery and SHIM Score

    • Some degree of ED always occurs after surgery to remove the prostate. The severity of the ED will depend on the stage and type of the cancer, the skill of your surgeon and the technique used. According to WebMD, one study reported that patients who underwent nerve-sparing surgery to remove the prostate (surgery that does not affect the nerve that causes erections) did better with a SHIM score than those who underwent non-nerve-sparing surgery.

    Radiation Therapy and SHIM Score

    • ED is the most common long-term complication of radiation therapy for prostate cancer. It occurs slowly and can take up to six months to develop.

    Reducing Risk of ED After Radiation Therapy

    • According to a report by the National Naval Medical Center in Maryland, the risk of ED is significantly reduced with the use of newer and more precise technologies in radiation therapy, such as intensity modulated radiotherapy (IMRT). This is a type of radiation therapy that minimizes the dose delivered to normal healthy tissue and delivers the same dose of radiation to all parts of the cancer. Speak to your doctor about new types of radiation therapy to minimize your risk of ED if you are concerned.

    Side Effects of IMRT

    • According to the Diagnostic Imaging website, the precision of IMRT leads to fewer side effects than traditional radiotherapy techniques. Side effects do occur, however, and may include the following: ED, loss of appetite, skin problems and fatigue.

    Hormone Therapy and SHIM Score

    • Hormone therapy for prostate cancer can lead to a decreased desire for sex and ED, with a corresponding reduction in a SHIM score approximately two to four weeks after initiation of therapy. WebMD says limited data showed that specialists at the Cleveland Clinic found that patients generally did not respond well to treatments for ED after treatment with hormone therapy. You may want to discuss this with your doctor if hormone therapy is an option for you and you are worried about its effects on your SHIM score.

    ED Treatments and SHIM Score

    • Your SHIM score may prompt your doctor to discuss ED treatments with you if you are having problems after your prostate cancer treatment. These may include oral medications, injections into the penis before intercourse, penile implants, medications placed inside the penis before intercourse and vacuum constriction devices.

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