DECREASED SEXUAL DESIRE SCREENER:
1. In the past, was your level of sexual desire or interest good and satisfying to you? Yes /No
2. Has there been a decrease in your level of sexual desire or interest? Yes/No
3. Are you bothered by your decreased level of sexual desire or interest? Yes /No
4. Would you like your level of sexual desire or interest to increase? Yes /No
5. Which of the factors below do you feel may be contributing to your current decrease in sexual desire or interest (check all that apply)?
• A. An operation, depression, injuries, or other medical condition.
• B. Medication, drugs, or alcohol you are currently taking
• C. Pregnancy, recent childbirth, menopausal symptoms
• D. Other sexual issues you may be having (pain, decreased arousal or orgasm)
• E. Your partner's sexual problems
• F. Dissatisfaction with your relationship or partner
• G. Stress or fatigue.