Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples.

BACKGROUND: The Female Sexual Distress Scale and the Female Sexual Distress Scale-Revised-herein called the Sexual Distress Scale (SDS and SDS-R)-are among the most widely used self-report instruments to assess sexual distress, but no version for use in the Portuguese population is available to date. AIM: The current study aimed to validate the Portuguese version of the SDS/SDS-R in samples of women and men with and without distressing sexual problems. METHODS: A sample of 1,109 participants without distressing sexual problems (761 women) and 382 participants with distressing sexual problems (283 women), ages ranging from 18 to 72 years, were used to examine the psychometric properties of the Portuguese SDS and SDS-R. OUTCOMES: Participants completed a survey that included a sociodemographic and health questionnaire, the Portuguese version of the SDS and SDS-R, and measures of sexual satisfaction, sexual quality of life, sexual function, dyadic adjustment, and psychological distress. RESULTS: Results indicated that the Portuguese SDS and the SDS-R assess 1 general domain of sexual distress and showed good evidences of validity based on content and on relations with other variables. Sexual distress was associated with poorer sexual function, satisfaction, and quality of life, with higher psychological distress, and lower dyadic adjustment. Internal consistency and test-retest (1 month) reliabilities were excellent. Tests of differential functioning of items indicated that the SDS and SDS-R scores can be used to compare women and men on sexual distress, but the SDS/SDS-R scores flagged differential functioning of items and test (DFIT) between participants with and without distressing sexual problems. CLINICAL TRANSLATION: Clinicians and researchers can now make use of the SDS and of the SDS-R in the Portuguese population, facilitating the assessment of sexual distress in clinical settings. STRENGTHS & LIMITATIONS: The Portuguese SDS/SDS-R scores can be compared between women and men, providing information on sexual distress independently of sexual function. With the current evidence, comparisons between individuals with and without distressing sexual problems should be made with caution, as the scores may be biased against the former. CONCLUSION: This study provides a validation of the Portuguese version of the SDS/SDS-R that can be used to assess sexual distress in Portuguese women and men and can be used to compare between these 2 groups. Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples. J Sex Med 2022;19:834-845.

Hard Times: Prostate Cancer Patients' Experiences with Erectile Aids.

BACKGROUND: Prostate cancer (PCa) treatments commonly lead to erectile difficulties. While the mainstay treatment is erectile aids (EAs) to promote erectile recovery, some men never use these treatments and those whose do use EAs often abandon them in the long-term. AIM: The goal of this study was to examine PCa patients' experiences with EAs, to elucidate relationships between experiences with EAs on psychological and sexual well-being, and to explore benefits and drawbacks to EA use. METHODS: A self-report survey including validated questionnaires was administered to examine PCa patients' use and perceptions of helpfulness of EAs, and to characterize associations between use, perceived helpfulness, and psychological and sexual well-being. The survey was followed by an open-ended prompt to explore participants' experiences with EAs. OUTCOMES: We surveyed 260 North American men, up to 25 years after receiving treatment for PCa. Three groups of patients were observed, including those who used EAs and perceived them to be helpful, those who used EAs and perceived them to be unhelpful, as well as a smaller group of patients who never used EAs. RESULTS: Around 80% of the sample were using or had used EAs. Despite the high frequency of use, not all men found EAs helpful. Men who used EAs and found them unhelpful reported poorer psychological and sexual well-being compared to men who didn't use aids or who used EAs but found them helpful. Results indicated both benefits and drawbacks to the use of EAs. Benefits related largely to the efficacy of the aid in promoting erections. A wide range of drawbacks were also reported. CLINICAL IMPLICATIONS: Given the negative sexual and psychological impacts associated with using EAs and finding them unhelpful, we suggest that researchers and health care providers should take care to proactively address potential challenges that are common with EA use, and also to consider the risks of failed attempts with EAs. STRENGTHS & LIMITATIONS: By using both scaled and open-ended questions, a more nuanced picture of the relative benefits and limitations of EA use within the PCa population is presented. As responses were not mandatory, a subset of participants provided comments about the use of EAs. Additionally, the sample was quite homogenous, with mostly white, American and well-educated participants, so it therefore lacks generalizability to other populations. CONCLUSION: This paper illustrates several challenges to EA use, while providing insight into reasons for abandonment of use of EAs. Walker LM, Sears CS, Santos-Iglesias P, et al. Hard Times: Prostate Cancer Patients' Experiences with Erectile Aids. J Sex Med 2021;18:1775-1787.

Preliminary validation of the Sexual Distress Scale-Short Form: Applications to Women, Men, and Prostate Cancer Survivors.

The Sexual Distress Scale (SDS) can be used to assess sexual distress in women, men, and prostate cancer (PCa) survivors. Despite its strong psychometric properties, researchers and clinicians could benefit from a short form of the scale. Two studies were conducted to develop (Study 1) and validate (Study 2) a short form of the SDS (SDS-SF) using samples of women, men, and PCa survivors from previous studies. Results of Study 1 suggested a 5-item SDS-SF. Study 2 showed that the SDS-SF items clustered in one factor with good fit across the three samples and excellent reliability. Sexual distress was associated with higher sexual bother, and poorer sexual satisfaction, sexual function, and relationship quality. The SDS-SF discriminated participants with and without distressing sexual problems. The SDS-SF facilitates the assessment of sexual distress in clinical settings by providing a quick way of screening patients with high levels of sexual distress.

On the Relationship Between Erectile Function and Sexual Distress in Men with Prostate Cancer.

Erectile difficulties are common after prostate cancer (PCa) treatment and are associated with sexual distress. However, the relationship between erectile function and sexual distress has yet to be carefully examined. This study had three goals: (1) examine the relationship between erectile function and sexual distress; (2) determine groups of men based on erectile function and sexual distress; and (3) examine the psychosexual characteristics of these groups. A cross section of 233 sexually active men after PCa treatment (age M = 64.90 years, SD = 7.50) completed an online survey containing demographic, health, and sexuality and relationship questionnaires. The relationship between erectile function and sexual distress was curvilinear. Four groups of men were found: good erectile function and low sexual distress, poor erectile function and high sexual distress, but also good erectile function yet high sexual distress, and poor erectile function and low sexual distress. Regardless of erectile function, men with greater sexual distress were more depressed, reported additional sexual concerns, placed less value on sex, were less sexually satisfied, and used protective buffering communication more frequently. They were also less likely to be satisfied with their adaptation to sexual changes and less likely to have found a solution to those changes. The relationship between erectile function and sexual distress is complex, characterized by a wide array of responses to erectile function (high and low distress) and multiple correlates of sexual distress. These results broaden the concept of sexual recovery after PCa treatment, which may assist clinicians and researchers to better address sexual problems after PCa treatment.

Psychometric Validation of the Sexual Distress Scale in Men with Prostate Cancer.

BACKGROUND: Different scales exist for the assessment of sexual distress in men with prostate cancer (PCa); however, these measures narrowly focus on distress associated with sexual function. AIM: To validate and examine the psychometric properties of the Sexual Distress Scale (SDS) and Sexual Distress Scale-Revised (SDS-R), which were recently validated for use within men, in samples of sexually functional and sexually dysfunctional men with PCa. METHODS: A sample of 538 men (with and without PCa and with and without sexual dysfunction) were used to examine the psychometric properties of the SDS. Confirmatory factor analysis followed by tests of measurement bias, calculations of reliability, and estimation of receiver operating characteristic (ROC) curves were used to examine the psychometric properties of the SDS and SDS-R. A subsample of 321 men completed the survey again 1 month later, and their responses were used to examine test-retest reliability. OUTCOMES: Participants completed the SDS and SDS-R, as well as measures of sexual bother and sexual concerns, sexual function, sexual attitudes, and mood states. RESULTS: The SDS and SDS-R assess 1 general domain of sexual distress; 1 violation of measurement invariance was found between men with and men without PCa, which limits the comparability of scores between these 2 groups. Internal consistency and test-retest reliabilities were above 0.93 and 0.82, respectively. Evidences of validity based on relations with other variables supported our predictions because sexual distress was associated with other measures of distress, sexual function, satisfaction, and mood and not correlated to sexual attitudes. Although the SDS and SDS-R discriminated between sexually functional and dysfunctional men, the accuracy of the cutoff scores was only moderate. CLINICAL TRANSLATION: This instrument can be used by researchers and clinicians to examine sexual distress and can be used to elucidate how sexual distress relates to sexual function, well-being, and quality of life. STRENGTHS AND LIMITATIONS: The SDS and SDS-R assess sexual distress independently of sexual function; however, with the current evidence, they should not be used to compare men with and men without PCa and to classify men with and men without sexual dysfunction. CONCLUSION: This study provides a validation of the SDS and SDS-R that can be used in samples of men with PCa and with and without sexual dysfunction for the assessment of distress. Santos-Iglesias P, Walker LM. Psychometric Validation of the Sexual Distress Scale in Men with Prostate Cancer. J Sex Med 2018;15:1010-1020.

A Systematic Review of Sexual Distress Measures.

BACKGROUND: Sexual distress is an important component of sexual dysfunction and quality of life and many different measures have been developed for its assessment. AIM: To conduct a literature review of measures for assessing sexual distress and to list, compare, and highlight their characteristics and psychometric properties. METHODS: A systematic review was conducted using Scopus and PubMed databases to identify studies that developed and validated measures of sexual distress. The main characteristics and psychometric properties of each measure were extracted and examined. OUTCOMES: Psychometrically validated measures of sexual distress and a summary of relative strengths and limitations. RESULTS: We found 17 different measures for the assessment of sexual distress. 4 were standalone questionnaires and 13 were subscales included in questionnaires that assessed broader constructs. Although 5 measures were developed to assess sexual distress in the general population, most were developed and validated in very specific clinical groups. Most followed adequate steps in the development and validation process and have strong psychometric properties; however, several limitations were identified. CLINICAL TRANSLATION: This literature review offers researchers and clinicians a list of sexual distress measures and relevant characteristics that can be used to select the best assessment tool for their objectives. STRENGTHS AND LIMITATIONS: A thorough search procedure was used; however, there is still a chance that relevant articles might have been missed owing to our search methodology and inclusion criteria. CONCLUSION: This is a novel and state-of-the-art review of assessment tools for sexual distress that includes valuable information measure selection in the study of sexual distress and sexual dysfunction. Santos-Iglesias P, Mohamed B, Walker LM. A Systematic Review of Sexual Distress Measures. J Sex Med 2018;15:625-644.

Mood, sexuality, and relational intimacy after starting androgen deprivation therapy: implications for couples.

BACKGROUND: Patients on androgen deprivation therapy (ADT), a common treatment for prostate cancer, report significant declines in quality of life and detrimental impact on their intimate relationships. ADT depresses a man's testosterone to castrate levels, leading to declines in sexual function, and changes in mood. These changes can have profound impact on couples' intimate relationships. METHOD: Patients undergoing ADT, and their consenting partners, were followed on a variety of outcomes relating to mood, sexual changes, and relational intimacy. Participants were assessed at baseline, 3 months, and 6 months. Changes in these three domains are documented. A dyadic analysis was conducted on the primary outcome of relational intimacy in order to assess the role of changes in mood and various aspects of sexuality on couples' intimate relationships. RESULTS: Declines were observed in the first 6 months on ADT for sexual function, sexual frequency, and relational intimacy. Sexual bother increased within the first 3 months on ADT. No changes in mood were observed. Dyadic analysis revealed important effects on couples' reports of relational intimacy. (A) Patient and partner ratings of emotional intimacy were higher when partners better understood the patients' mood state. (B) Patient and partner ratings of sexual intimacy were higher when couples were more sexually active. CONCLUSIONS: The current study confirms that patients experience reduced sexuality and relational intimacy during the first 6 months on ADT. Specific facets of relational intimacy are improved with increased sexual activity and also when partners recognize the emotional changes that patients are experiencing.

Psychometric Validation of the Female Sexual Distress Scale in Male Samples.

This manuscript is the first to examine the psychometric properties of the Female Sexual Distress Scale in samples of sexually functional and dysfunctional men, herein called the Sexual Distress Scale (SDS). A sample of 127 sexually dysfunctional men and 267 sexually functional men completed an online survey that included a sociodemographic questionnaire, a health questionnaire, the SDS, as well as measures of sexual bother and concerns, sexual function, sexual attitudes, and mood states. We also used a sample of 188 sexually dysfunctional and 155 sexually functional women from previous studies. Results showed that the SDS assesses one general domain of sexual distress. The factor structure was invariant across gender and sexual function status. The SDS also showed good content, construct, and criterion validity, as well as good internal consistency reliability (Cronbach's alpha) and test-retest reliability. Finally, the SDS discriminated well between sexually functional and sexually dysfunctional men. These results show that the SDS is a reliable and valid tool for assessing sexual distress in men. This instrument can be used by researchers and clinicians to examine sexual distress and can be used to elucidate how sexual distress relates to sexual function, well-being and quality of life.

Validation of the Sexual Inhibition and Sexual Excitation Scales (SIS/SES) in Portugal: Assessing Gender Differences and Predictors of Sexual Functioning.

The Sexual Inhibition and Sexual Excitation Scales (SIS/SES) were developed to assess individual propensities for sexual excitation and sexual inhibition in men and women. The objective of the present study was to validate the Portuguese version of the SIS/SES and to investigate the degree to which SIS/SES scores predict different dimensions of Portuguese men's and women's sexual functioning. Gender differences were also examined. A community sample of 370 Portuguese men and 373 women completed self-report measures of sexual function (IIEF, Rosen et al., 1997; FSFI, Rosen et al., 2000) and of the propensity for sexual inhibition and sexual excitation (SIS/SES, Janssen et al., 2002a). Exploratory factor analysis revealed a three-factor solution further supported by confirmatory factor analysis. The three factors identified resemble the original ones, and reliability analyses indicated they have both satisfactory internal consistency and stability over time. Age and Sexual Inhibition Due to the Threat of Performance Failure (SIS1) were both significant negative predictors of men's sexual desire, erectile function, and orgasm. Sexual Excitation (SES) was a positive predictor of sexual desire in both men and women and of men's erectile function and of women's lubrication and orgasm. Age was also a significant and negative predictor of women's sexual desire. Significant gender differences were found for all three SIS/SES scales with men having significantly higher excitation and lower inhibition scores as compared to women. The Portuguese version of the SIS/SES was shown to be suitable for use within the Portuguese population in both clinical and basic research. Our findings provide further cross-cultural validation of the Dual Control Model of Sexual Response and underscore the importance of the role of excitatory and inhibitory processes in women's and men's sexual functioning and response.

Validation of the Sexual Sensation Seeking Scale in Spanish Samples.

The aim of this study was to validate the Sexual Sensation Seeking Scale (SSSS; Kalichman, 2011) in Spanish samples. Two independent studies were conducted. In Study 1, we examined the factor structure of the SSSS in a sample of 1,272 heterosexual undergraduate students (40.0% men, 60.0% women). Results revealed a 2-factor structure. Factor 1 was related to physical sexual sensations and risky sexual behaviors and Factor 2 was related to exploratory or novel sex. A confirmatory factor analysis confirmed this factor structure in a sample of 373 community adults (33.8% men, 66.2% women). Two items were deleted, resulting in a final version composed of 8 items. This version showed good test-retest reliability and evidence of its concurrent validity. In Study 2, the factor structure was further confirmed in a sample of 1,596 university students (28.8% men, 71.2% women). More evidence of construct validity was provided, which revealed that higher levels of sexual sensation seeking were associated with more frequent sexual risk behaviors and poorer sexual health. Internal consistency reliability did not reach acceptable levels on all of the subscales. Results suggest that, although it has been used before, this scale needs a revision before its use in Spanish-speaking contexts.

Understanding the Sexual Satisfaction of Women With Provoked Vestibulodynia and Their Partners: Comparison With Matched Controls.

Provoked vestibulodynia (PVD)-a recurrent, localized vulvar pain-interferes with couples' sexual relationships as evidenced by lower sexual satisfaction compared to controls. Little is known about what components of sexual satisfaction contribute to this lower satisfaction. Using the Interpersonal Exchange Model of Sexual Satisfaction (IEMSS), we compared the sexual exchanges (sexual rewards and costs, relative sexual rewards and costs, balance of sexual rewards and costs, balance of relative sexual rewards and costs, equality of sexual rewards and costs) and sexual satisfaction of 50 women with PVD and their male partners to 50 matched-control couples. We also compared women with PVD and their partners on these same components. Participants completed standardized measures of sexual exchanges and sexual satisfaction. Women with PVD and their partners reported lower relative sexual rewards, a less favorable balance of relative sexual rewards to costs, and lower sexual satisfaction than controls, although differences were larger for women. Women with PVD also reported lower levels of sexual rewards, higher levels of sexual costs, a less favorable balance of sexual rewards to costs, and lower equality of sexual costs, than control women. Findings identify IEMSS exchange components that may contribute to overall lower satisfaction in couples affected by PVD.

Sexual Satisfaction in Spanish Heterosexual Couples: Testing the Interpersonal Exchange Model of Sexual Satisfaction.

The study of sexual satisfaction in Spain is scarce and has proceeded atheoretically. This study aimed at examining sexual satisfaction in 197 Spanish heterosexual couples based on the Interpersonal Exchange Model of Sexual Satisfaction. Men and women reported equal satisfaction. Men's sexual satisfaction was predicted by their own relationship satisfaction, balance of sexual rewards and costs, and comparison level of sexual rewards and costs. Women's sexual satisfaction was predicted by their own relationship satisfaction, balance of sexual rewards and costs, comparison level of sexual rewards and costs, equality of sexual costs, and their partner's balance of sexual rewards and costs. These results provide with a better understanding of the mechanisms that explain sexual satisfaction in Spanish couples. Implications for research and therapy are discussed.

Sexual Activity of Older Adults: A Systematic Review of the Literature.

Objective: The goal was to conduct a literature review of studies that examined sexual activity in older adults. Method: A systematic search was conducted to identify studies that had examined sexual activity in adults aged 60 years and older. The main characteristics of each study and results were examined and reported according to PRISMA guidelines. Results: Sixty-three articles were found. These articles were classified into three main groups based on the results they presented: percentage of older adults that were sexually active; frequency of sexual activity; and type of sexual activities. The results show that older adults are sexually active, engage in frequent sexual activity, and participate in a wide variety of activities. Conclusions: Although older adults remain sexually active, differences in the way sexual activity is assessed limit the drawing of firm conclusions and our understanding of the sexual activity of older adults. We propose a series of recommendations to gain a better understanding of this topic.

Definitions of Having Sex in Older Men and Women and Their Relationship with Sexual Well-Being.

The goal of this study was to explore the sexual activities that older adults consider as having had sex and to examine correlates of the ways that older men and women define sex. A sample of 286 men and women aged 60 years and older who were involved in a romantic relationship were recruited online from Prolific and Facebook advertisements. Participants were presented a list of 19 different sexual activities and asked whether they would think they had sex if they engaged in each one of those activities. Results showed that penetrative sexual activities were found to be the most likely endorsed as having had sex, followed by genital non-penetrative activities, masturbation activities, and non-genital contact. Greater sexual frequency for a sexual activity was associated with endorsing that same activity as having had sex. A cluster analysis revealed five different groups of individuals based on the activities that they considered as having had sex. Only small differences in sexual wellbeing were found among these groups of individuals. The way older men and women define sex is complex and shows great variability. Our results have important implications for the operationalization and assessment of sexual activity. Other implications for healthcare and future research are discussed.

Predictors of sexual assertiveness: the role of sexual desire, arousal, attitudes, and partner abuse.

This study was conducted to test interpersonal, attitudinal, and sexual predictors of sexual assertiveness in a Spanish sample of 1,619 men and 1,755 women aged 18-87 years. Participants completed measures of sexual assertiveness, solitary and dyadic sexual desire, sexual arousal, erectile function, sexual attitudes, and frequency of partner abuse. In men, higher sexual assertiveness was predicted by less non-physical abuse, more positive attitudes toward sexual fantasies and erotophilia, higher dyadic desire, and higher sexual arousal. In women, higher sexual assertiveness was predicted by less non-physical abuse, less solitary sexual desire and higher dyadic sexual desire, arousal, erotophilia, and positive attitudes towards sexual fantasies. Results were discussed in the light of prevention and educational programs that include training in sexual assertiveness skills.

Sexual satisfaction in prostate cancer: a multi-group comparison study of treated patients, patients under active surveillance, patients with negative biopsy, and controls.

PURPOSE: Erectile function changes after prostate cancer (PCa) treatment are well documented, but less understood is the relative impact of prostate biopsy and active surveillance on sexual well-being. It is unknown whether potential negative impacts are exclusive to patients who have been treated for PCa, or whether the diagnosis itself or the experience of biopsy may also impact sexual well-being. Sexual satisfaction is an important yet understudied indicator of sexual well-being in this population. This study examines sexual satisfaction and its predictors across several comparison groups to explore relative impact. METHODS: At baseline and 12 months, questionnaire data was collected in four samples: (1) following PCa treatment, (2) active surveillance, (3) negative prostate biopsy result, and (4) controls receiving no biopsy or treatment. Predictors assessed included group, erectile function, communication style, and partner involvement. RESULTS: Sexual satisfaction declined in the active treatment group, no changes were observed in active surveillance or non-PCa control, and improvements were observed in the biopsy group. Predictors of sexual satisfaction over and above erectile function included restrictive communication (i.e. protective buffering) and perceived partner involvement. For higher levels of erectile function, a higher perceived degree of partner involvement was protective of sexual satisfaction. CONCLUSION: Sexual satisfaction is an important indicator of sexual well-being and is negatively impacted following PCa treatment, but not active surveillance or prostate biopsy. IMPLICATIONS FOR CANCER SURVIVORS: Communication and partner involvement are potentially modifiable factors to be considered for intervention and may promote sexual satisfaction following PCa treatment. Patients experiencing negative biopsy, who note lower sexual satisfaction may experience improved satisfaction with time, and those under active surveillance who worry about sexual satisfaction may find reassurance from these results.

Implementation of individually tailored treatment plans in a group-based intervention for women with mixed vulvo-vaginal and sexual health concerns following cancer treatment: A feasibility study.

PURPOSE: This study evaluated a professionally-led, group-based vulvo-vaginal and sexual health (VSH) workshop for women diagnosed with cancer. The study goals were to: (1) implement and assess a novel group intervention for diverse VSH concerns; (2) explore post-workshop changes in symptom bother, motivation to use VSH treatments, and frequency of VSH treatment use; (3) examine post-workshop changes in sexual well-being. METHODS: A group-based educational workshop to address a variety of VSH concerns was developed and implemented. During the workshop, participants created an individualized treatment plan by selecting from various VSH treatment options presented. Treatment plan follow-ups were administered online at one-, two-, and three-months post-workshop. At baseline and three-month follow-up, participants completed online questionnaires to assess self-reported vulvo-vaginal symptoms, sexual function, sexual distress, and use of VSH strategies. RESULTS: 195 participants (age 20-81) attended workshops over a 2.5-year period. Individualized treatment plans were effectively completed by most participants (92%). Preliminary results show decreases in bother severity associated with VSH concerns post-workshop, stabilizing after 2 months. At three-month follow-up, participants reported increased use of VSH treatment strategies. Sexual satisfaction, sexual distress, and emotional impact of vulvovaginal symptoms also improved. CONCLUSIONS: Workshop attendance was associated with increased uptake of VSH treatment strategies and improvements in several parameters of sexual well-being. Findings indicate that individualized treatment plans can be implemented effectively in a group setting and that a one-time, group-based educational workshop can meaningfully impact VSH-related behavior change, reduce vulvo-vaginal symptom bother and promote sexual well-being in patients with diverse VSH concerns.

[Validation of Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) in a Spanish population]. / Validación del Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) en población española.

OBJECTIVE: Due to the lack of psychometric studies using the Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ) in Spain, its Spanish validation is proposed in the present study, by analysing its reliability and validity. DESIGN: Cross-sectional descriptive study. SETTING: General population. Conducted in 20 provinces. PARTICIPANTS: The sample consisted of 3,050 participants (45.41% men and 54.59% women) and was selected using a quota convenience sampling procedure. They ranged in age from 18 to 83 years-old (M=41.51; SD=13.45). MAIN MEASUREMENTS: Spanish versions of the MGH-SFQ, Sexual Assertiveness Scale, Sexual Desire Inventory, and Index of Sexual Satisfaction. RESULTS: The MGH-SFQ showed a single dimensional structure, which explained 71.35% of variance in men and 83.56% in women. Reliability values were .90 and .93, respectively. Convergent validity was adequate as their scores were positively correlated to initiation sexual assertiveness, dyadic sexual desire, and sexual satisfaction. The MGH-SFQ identified that females showed more sexual dysfunctions than males, and detected more sexual dysfunctions as age increases. CONCLUSIONS: The Spanish validation of the MGH-SFQ is a reliable and valid self-reporting questionnaire to assess sexual dysfunctions in Spain. Its psychometric goodness of fit, together with its brevity and ease of use, make it a useful instrument to detect overall, as well as particular sexual dysfunctions.

Impact of Vulvovaginal Symptoms in Women Diagnosed with Cancer: A Psychometric Evaluation of the Day-to-Day Impact of Vaginal Aging Questionnaire.

Background: Vulvovaginal symptoms (VVS), such as dyspareunia, dryness, and itching, are common following cancer treatment and can negatively impact sexual well-being, daily activities, mood, self-concept, and overall quality of life. Information about the impact of VVS after cancer treatment is scarce, mainly because of a dearth of validated measures. This study aimed to validate the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire, which assesses impact of VVS on women's lives, in a sample of women with cancer. Methods: Women diagnosed with cancer (n = 202) completed a questionnaire package, including the DIVA and measures of VVS, sexual function, and sexual distress. Data were collected as part of study evaluating an educational workshop. Confirmatory factor analysis (CFA) was used to examine whether the factor structure of the DIVA in this population reflected that of the original validation study. Results: CFA showed that the DIVA assesses VVS impact on four domains: activities of daily living, sexual functioning, emotional well-being, and self-concept and body image. All subscales showed excellent internal consistency reliability; however, item analyses indicated that items in the activities of daily living subscale showed very low means. Correlations with sexual function and distress provided evidence that the DIVA assesses impact of VVS. Conclusions: This is the first study aimed at validating the DIVA in women treated for cancer. Results provide evidence of the DIVA's utility in assessing the impact of VVS on four relevant domains. Although issues with certain scale items need to be resolved in future research, the DIVA provides opportunity to understand the impact of VVS after cancer treatment, to address unmet needs of cancer survivors.