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Table 2 Sexual function outcome measures

From: Management of sexual dysfunction in breast cancer survivors: a systematic review

  Assessment descriptiona Scoring rubric
Arizona Sexual Experience Scale (ASEX) [68, 69] 5-item scale measuring sexual drive, arousal, vaginal lubrication, orgasm, and satisfaction • 6-point Likert scale (1 – 6); total score 5 – 30
• Higher scores indicate greater sexual dysfunction.
• Score > 19 indicates sexual dysfunction.
Body Image Relationships Scale (BIRS) [70] 11-item Appearance and Sexuality Subscale measuring satisfaction with sexual activity, physical appearance, and body image • 5-point scale (1 – 5); total score 11 – 55
• Higher scores indicate greater impairment.
Cancer Rehabilitation Evaluation System (CARES) [71] Includes 4-item Sexual Interest, 4-item Sexual Function, and 18-item Marital Issues Subscales • 5-point scale (0 – 4)
• Higher scores indicate greater impairment.
Changes of Sexual Functioning Questionnaire (CFSQ) [72] Includes 3-item Desire/Interest, and 2-item Frequency/Pleasure Subscales • 5-point Likert scale (1 – 5); total score 5 – 25
• Higher scores indicate lesser impairment.
Derogatis Inventory of Sexual Functioning (DISF-SR) [73] 4-item subscale measuring sexual drive and relationship satisfaction • 5- or 9-point scale (depending on item)
• Higher scores indicate less impairment.
EORTC Quality of Life Questionnaire (QLQ) Breast Cancer Module [74] 23-item Sexual Function and Body Image Subscales measuring breast cancer therapy side effects • 4-point rating scale; total score 0 – 100 (after linear transformation)
• Higher scores indicate less impairment.
Female Sexual Function Index (FSFI) [75] 19-item scale measuring sexual desire, arousal, lubrication, orgasm, satisfaction, and pain • 6-point Likert scale (0 – 5); total score 0 – 36
• Higher scores indicate better sexual function.
• Score < 26.5 suggests sexual dysfunction.
Functional Assessment of Cancer Therapy (FACT) [76] 18-item Endocrine Symptoms Subscale (FACT-ES) measuring hormone-related/ menopausal symptoms of breast cancer • Total score 0 – 72
• Higher scores indicate fewer symptoms.
Marital Intimacy Questionnaire [77] 8-item scale measuring marital intimacy • 4-point Likert scale (1 – 4); total score 8 – 32
• Higher scores indicate less impairment.
Medical Outcomes Study [78] 4-item Sexual Functioning Subscale measuring sexual dysfunction symptoms • 6-point Likert scale (1 – 6)
• Higher scores indicate more symptoms.
Menopausal Sexual Interest Questionnaire (MSIQ) [79] 10-item Sexual Satisfaction Subscale measuring desire, responsiveness, and satisfaction in postmenopausal women • 7-point Likert scale (1-7); total score 10 - 70
• Higher scores indicate less impairment.
Menopausal Symptom Score [80] Adapted 7-item scale measuring study-specific menopausal symptoms • 5-point Likert scale (0 – 4); total score 0 – 28
• Higher scores indicate more symptoms.
Profile of Female Sexual Function (PFSF) [81] 37-item scale measuring sexual desire, arousal, orgasm, pleasure, concerns, responsiveness, and self-image • 5-point Likert scale (1 – 5); total score 0 – 100 (after linear transformation)
• Higher scores indicate less impairment.
Psychological Adjustment to Illness Scale (PAIS) [82] 46-item clinical interview with Sexual Relationships (PAIS-SR) and Sexual Problems Subscales measuring psychological and social adjustment to illness • 4-point scale (0 – 3)
• Higher scores indicate poorer adjustment.
• Score < 35 = good; 35-51 = fair; > 51 = poor
Quality of Marriage Index (QMI) [83] 6-item scale measuring marital quality • 7-point bipolar scale (1 – 7); total score 6 – 42
• Higher scores indicate better quality of marriage.
Study-Specific Scales [50] Study-specific scales measuring frequency of sexual desire, intercourse, masturbation, orgasm, initiative for sex, and relationship satisfaction • Higher scores indicate less impairment.
Study-Specific Scales [51] Study-specific items measuring sexual satisfaction, relationship satisfaction, dyspareunia, and comfort with sexuality • 5- or 6-point Likert scale (depending on item)
• Higher scores indicate less impairment.
Sexual Activity Questionnaire (SAQ) [84] 10-item scale with 3 main subscales measuring: Pleasure (SAQ-P; desire, enjoyment, satisfaction), Discomfort (SAQ-D; vaginal dryness, dyspareunia), Habit Subscale (SAQ-H; frequency) • 4-point Likert scale (0 – 3); total score 0 – 24
• Higher scores indicate less impairment.
Sexual Desire Subscale of Brief Index of Sexual Function (BISF) [85] Includes 8-item Sexual Desire and 9-item Sexual Arousal Subscales • 6- or 7-point Likert scale (0 – 5 or 0 – 6)
• Higher scores indicate less impairment.
Sexual Dysfunction Scale [57] 25-item study-specific scale with 3 subscales measuring: Behavioral (vaginal dryness, dyspareunia, and frequency), Evaluative (interest, arousal, and satisfaction), Body image (sense of attractiveness, impact of weight change and hair loss) • Total score 0 – 100
• Higher scores indicate less impairment.
Sexual Function Subscale of Greene Climacteric Scale (GCS) [86] 21-item scale with 4 subscales measuring: Vasomotor Symptoms (2 items), Somatic Symptoms (7 items; headaches and muscle/joint pains), Psychological Symptoms (11 items), Sexual Function (1 item; sexual interest) • 4-point scale (0 – 3); total score 0 – 6 (vasomotor), 0 – 21 (somatic), 0 – 33 (psychological), 0 – 3 sexual function; combined total score 0 – 63
• Higher scores indicate more symptoms.
Sexual Problems Frequency [45] Adapted subscale from BIRS measuring frequency of sexual problems • 5-point Likert scale (0 – 4)
• Higher scores indicate greater impairment.
Sexual Satisfaction Scale (SSS) [61, 87] Study-specific items measuring relational sexual satisfaction for male and female partners • Higher scores indicate less impairment.
Sexual Satisfaction Scale (SSS) [88] 17-item study-specific scale measuring sexual satisfaction among Korean women • 4-point Likert scale (1 – 4); total score 17 – 68
• Higher scores indicate less impairment.
Sexual Self Schema Scale [89] 50- item, trait-adjectives scale measuring women’s sexual self-perception • 7-point Likert scale (0 – 6)
• Higher scores indicate better self-perception.
Visual Analog Scale for Vaginal Dryness and Dyspareunia [29] Linear rating scale measuring vaginal dryness and pain • 10-point scale (0 – 10)
• High scores indicate greater impairment.
Vaginal Atrophy Symptom [29, 9092] Adapted 3-item scale measuring vaginal dryness, itching/irritation, dyspareunia • 4-point Likert scale (0 – 3); total score 0 – 9
• Higher scores indicate greater impairment.
Vaginal Dryness, Vaginal Itching, Dyspareunia [23, 32] Study-specific items measuring vaginal dryness, vaginal itching, and dyspareunia • 5- or 10-point Likert scale (depending on study)
• Higher scores indicate greater impairment.
Vaginal Health Index (VHI) [93, 94] 6-parameter gynecological examination rating appearance of vaginal mucosa • Score of 1 to 5; total score 6 – 30
• Higher index indicates healthier appearance.
Vaginal Maturation Index (VMI) [91, 95] Gynecological examination determining vaginal atrophy • Score of 0 – 100 (%)
• Higher scores indicate less vaginal atrophy.
• A score of < 50 indicates vaginal atrophy.
Vaginal Symptoms Score (VSS) [24, 95] Study-specific scale measuring severity of vaginal atrophy • 5-point Likert scale (0 – 4)
• Higher scores indicate more symptoms.
  1. aAll scales were designed as self-report questionnaires (unless otherwise reported as an examination, interview, or visual analog scale)