Social Functioning

Sexual Problems Measures

Published in: Measuring Functioning and Well-Being: The Medical Outcomes Study Approach / edited by Anita L. Stewart and John E. Ware, Jr., (Durham, N.C.: Duke University Press, 1992), Chapter 11, p. 194-204

by Cathy D. Sherbourne

Sexual functioning is commonly defined by sexual problems and dysfunction. The MOS limited the definition to include any impairment of the capacity of an adult man or woman to achieve sexual arousal and orgasm. Types of dysfunctions are erectile dysfunction or retrograde ejaculation in the male, vaginal infections or dyspareunia in the female, and inadequate sexual interest or sexual pleasure in the male and the female. Two basic issues were addressed in developing a measure of sexual functioning for MOS: identifying specific sexual problems that could be caused by the four chronic MOS conditions or that might result from intervention and treatments of those conditions; and practical issues related to how best to word the sexual problem items, the appropriate response format to use, and how to deal with persons who did not have a partner or sexual encounter during the time frame of interest. MOS was interested in assessing general sexual problems and wanted to identify problems across conditions. Therefore, rather than asking if there was a problem, items asked the degree to which sexual problems bother the subject or cause distress. A mean sexual problem score was calculated from people with a major medical condition without depression; with both a major medical condition and depression; and with major depression but no medical condition. Scores were lowest for patients with a medical condition but no depression, and highest for depressed patients. For the future, MOS recommends including a number of other items to increase the ability to detect differences (e.g., separate items for obtaining and maintaining an erection, difficulty in ejaculation).

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.