Sexually active in past 4 weeks *
Select...
Yes
No
If No, some items are scored 0.
Over the past 4 weeks, how often did you feel sexual desire or interest? *
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Almost always or always (5)
Most times (more than half the time) (4)
Sometimes (about half the time) (3)
A few times (less than half the time) (2)
Almost never or never (1)
Over the past 4 weeks, how would you rate your level (degree) of sexual desire or interest? *
Select...
Very high (5)
High (4)
Moderate (3)
Low (2)
Very low or none at all (1)
Over the past 4 weeks, how often did you feel sexually aroused during sexual activity or intercourse? *
Select...
Almost always or always (5)
Most times (4)
Sometimes (3)
A few times (2)
Almost never or never (0)
Over the past 4 weeks, how would you rate your level of sexual arousal during sexual activity or intercourse? *
Select...
Very high (5)
High (4)
Moderate (3)
Low (2)
Very low or none at all (0)
Over the past 4 weeks, how confident were you about becoming sexually aroused during sexual activity or intercourse? *
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Very high confidence (5)
High confidence (4)
Moderate confidence (3)
Low confidence (2)
Very low or no confidence (0)
Over the past 4 weeks, how often have you been satisfied with your arousal during sexual activity or intercourse? *
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Almost always or always (5)
Most times (4)
Sometimes (3)
A few times (2)
Almost never or never (0)
Over the past 4 weeks, how often did you become lubricated during sexual activity or intercourse? *
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Almost always or always (5)
Most times (4)
Sometimes (3)
A few times (2)
Almost never or never (0)
Over the past 4 weeks, how difficult was it to become lubricated during sexual activity or intercourse? *
Select...
Extremely difficult or impossible (0)
Very difficult (1)
Difficult (2)
Slightly difficult (3)
Not difficult (4)
Over the past 4 weeks, how often did you maintain your lubrication until completion of sexual activity or intercourse? *
Select...
Almost always or always (5)
Most times (4)
Sometimes (3)
A few times (2)
Almost never or never (0)
Over the past 4 weeks, how difficult was it to maintain your lubrication until completion of sexual activity or intercourse? *
Select...
Extremely difficult or impossible (0)
Very difficult (1)
Difficult (2)
Slightly difficult (3)
Not difficult (4)
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you reach orgasm? *
Select...
Almost always or always (5)
Most times (4)
Sometimes (3)
A few times (2)
Almost never or never (0)
Over the past 4 weeks, when you had sexual stimulation or intercourse, how difficult was it for you to reach orgasm? *
Select...
Extremely difficult or impossible (0)
Very difficult (1)
Difficult (2)
Slightly difficult (3)
Not difficult (4)
Over the past 4 weeks, how satisfied were you with your ability to reach orgasm during sexual activity or intercourse? *
Select...
Very satisfied (5)
Moderately satisfied (4)
About equally satisfied and dissatisfied (3)
Moderately dissatisfied (2)
Very dissatisfied (0)
Over the past 4 weeks, how satisfied have you been with your overall sexual life? *
Select...
Very satisfied (5)
Moderately satisfied (4)
About equally satisfied and dissatisfied (3)
Moderately dissatisfied (2)
Very dissatisfied (1)
Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner? *
Select...
Very satisfied (5)
Moderately satisfied (4)
About equally satisfied and dissatisfied (3)
Moderately dissatisfied (2)
Very dissatisfied (1)
Over the past 4 weeks, how satisfied have you been with your overall sexual relationship with your partner? *
Select...
Very satisfied (5)
Moderately satisfied (4)
About equally satisfied and dissatisfied (3)
Moderately dissatisfied (2)
Very dissatisfied (1)
Over the past 4 weeks, how often did you experience discomfort or pain during vaginal penetration? *
Select...
Almost always or always (0)
Most times (1)
Sometimes (2)
A few times (3)
Almost never or never (5)
Over the past 4 weeks, how often did you experience discomfort or pain following vaginal penetration? *
Select...
Almost always or always (0)
Most times (1)
Sometimes (2)
A few times (3)
Almost never or never (5)
Over the past 4 weeks, how would you rate your level (degree) of discomfort or pain during or following vaginal penetration? *
Select...
Very high (0)
High (1)
Moderate (2)
Low (3)
Very low or none at all (5)
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