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. 2015 Apr 18;30(10):1468–1475. doi: 10.1007/s11606-015-3333-3

Table 6.

Recommended Clinical Screener

In the past 12 months, has there ever been a period of 3 months or more when you had any of the following problems or concerns? Check all that apply.
 You wanted to feel more interest in sexual activity
 You had difficulty with erections (penis getting hard or staying hard) – MEN ONLY
 Your vagina felt too dry – WOMEN ONLY
 You had pain during or after sexual activity
 You had difficulty having an orgasm
 You felt anxious about sexual activity
 You did not enjoy sexual activity
 Some other sexual problem or concern
 No sexual problems or concerns