What did @liquivida actually say?
The creator described a clinical intake process for patients reporting erectile dysfunction or reduced sexual performance. They said the first step is a detailed history, followed by administering a "shim score" (SHIM), which they described as a tool that "classifies their performance as mild, moderate, severe." They framed this as guiding treatment decisions. Credit where it's due: that's a reasonable description of standard intake protocol, even if the delivery was rough.
The core claim is that SHIM scoring helps clinicians categorize ED severity and direct treatment. That's defensible. But the video's caption goes further, claiming Liquivida gets to the "root cause" of ED, which is a bigger promise than a five-question self-report inventory can deliver on its own.
Does the science back this up?
The SHIM, also called the IIEF-5 (International Index of Erectile Function-5), is a validated, widely used screening tool. Rosen et al. (1999, Urology) established its reliability for classifying ED severity across five categories: no ED, mild, mild-to-moderate, moderate, and severe. So the creator's claim that it classifies function as mild, moderate, or severe is mostly accurate, just slightly compressed. The actual tool has five classifications, not three.
Where the science gets more complicated is the "root cause" framing. A self-reported questionnaire screens for severity, it does not diagnose etiology. Determining whether ED stems from low testosterone, vascular disease, neurological issues, or psychological factors requires additional workup. Hatzimouratidis et al. (2010, European Urology) make clear in EAU guidelines that history and questionnaires are the starting point, not the endpoint, of a root-cause evaluation.
What did they get wrong (or right)?
They got the basic workflow right. Detailed history plus a validated screening tool is exactly what guidelines recommend before jumping to treatment. That's not nothing. A lot of direct-to-consumer telehealth skips straight to prescriptions, so pointing to structured intake is genuinely worth acknowledging.
What they got wrong, or at least glossed over, is the gap between "classifying severity" and "finding the root cause." SHIM tells you how bad the problem is, not why it exists. If a patient scores in the severe range, you still need hormonal labs, cardiovascular risk assessment, and possibly a psychological screen before you know what you're actually treating. The caption's promise to get to the "root cause" overstates what a questionnaire-based intake can deliver. Buvat et al. (2010, Journal of Sexual Medicine) found that organic and psychological causes of ED frequently co-exist and require multi-modal assessment to untangle.
What should you actually know?
SHIM is a good screening tool, not a diagnostic workup. If you're seeking care for ED, the questionnaire is step one of several. A complete evaluation should include testosterone, LH, FSH, prolactin, fasting glucose, and lipid panels at minimum. Cardiovascular risk matters here: ED in men under 50 is increasingly recognized as an early marker of endothelial dysfunction. Vlachopoulos et al. (2013, European Heart Journal) found that ED is an independent predictor of major adverse cardiovascular events.
Treatment decisions should follow that full picture. Low-T confirmed by labs is a different clinical situation than ED with normal testosterone and uncontrolled diabetes. Conflating them because both score poorly on SHIM leads to mismatched treatment. The SHIM score is a useful map coordinate, not the whole map.
- Ask any provider what additional testing they run after SHIM scoring before they recommend treatment.
- If a provider jumps straight to testosterone after a questionnaire alone, that is a red flag.
- ED can be a cardiovascular warning sign. A good workup treats it as such.