Assessing Sexual Health: A Comprehensive Scoping Review of Measurement Questionnaires.

This study is a kind of scoping review carried out in accordance with Arksey and O'Malley's five-phase process, which consists of the following stages: designing the research question; finding and selecting pertinent studies; documenting and gathering data; and concluding, summarizing, and reporting the results. This study aimed to review all available sexual health questionnaires to assess the sexual health level of people. The questions are as follows: What sexual health questionnaires are available? What concepts and dimensions do these questionnaires cover? MeSH in the PubMed database, publications, and the use of dictionaries—which served as a foundation for other databases—were used to define the search strategy's keywords. The following keywords were used independently to find relevant English articles: sexual health questionnaires, sexuality questionnaires, sexual pleasure questionnaires, sexual behavior questionnaires, sexual function questionnaires, sexual dysfunction questionnaires, sexual activity questionnaires, sexual consciousness questionnaires, sexual motivation questionnaires, sexual satisfaction questionnaires, sexual esteem questionnaires, sexual assertiveness questionnaires, sexual arousal questionnaires, sexual adjustment questionnaires, sexual depression questionnaires, sexual harassment questionnaires, sexual coercion questionnaires, sexual trauma questionnaires, sexual violence questionnaires, sexual self-perception questionnaires, and using search operators such as AND, OR, NOT in the Scopus, Web of Science, PubMed, and ProQuest databases between January 1,2000, and January 31, 2023. Every extracted article was loaded into the Endnote program. Articles were manually searched by consulting the sources of a few chosen articles. The selection of pertinent papers was done by examining the abstract and title of the manuscripts. After entering the searched articles based on the inclusion criteria of the Endnote software and removing duplicates, the titles and abstracts were screened. In the next step, the full texts of the manuscripts were studied and after the selection process, the primary articles were included in the scoping review study. The data of the articles were extracted using a researcher-made form for summarization. The inclusion and exclusion criteria are summarized in Table 1 . The qualified articles were selected from a total of 1783 articles that were found by searching databases (n = 1752) and by hand (n = 31 articles). A total of 653 manuscripts were eliminated because they were duplicates, 775 articles were evaluated for eligibility, and 65 articles were chosen after reading their full texts and considering the inclusion and exclusion criteria. This review was conducted and reported using the PRISMA guidelines ( 9 ) ( Figure 1 ). Following the selection of articles that met the inclusion criteria, a data extraction form was created, wherein the names of the authors, the publication date, the title, the research population, the validity and reliability of the questionnaires, the type of questionnaires, the psychometric characteristics, the country, the study method, and the results were documented. The most important findings are shown in Table 2 . PRISMA flow diagram of literature review 1 . Not applicable

From a total of 1783 articles obtained through searching databases (n = 1752) and manually (n = 31 articles), 653 manuscripts were removed due to duplication, 775 articles were assessed for eligibility, and finally, 65 articles were selected based on the inclusion and exclusion criteria and after reading their full text. The following text presents the results obtained from the review of studies according to the research question. The questionnaires under review were either designed for the first time, or being analyzed psychometrically, or they were a translation and adaptation of the built questionnaires. However, the final questionnaires in Table 1 can be classified based on the dimensions suggested by the WHO for sexual health, such as physical, psychological, and social dimensions. First, the general features of the questionnaires are reviewed and then the details of the categories are discussed. A questionnaire designed to examine the perceived effects of MS symptoms on sexual activity, its satisfaction, and the quality of intimate relationships was included in the study under review. The first questionnaires, as indicated in Table 2 , were related to the year 2000 and measured the primary aspects of women's sexuality, which change under the influence of hormonal changes ( 10 , 11 ). The questionnaires were designed in the United States, England, Canada, Denmark, Japan, Turkey, Spain, Norway, France, Iran, Brazil, Ukraine, Croatia, Italy, China, Poland, Israel, Netherlands, Portugal, Nepal, Spain, Greece, and Sweden. According to the research conducted for these studies, the European continent is the subject of the largest and most varied questionnaires, followed by Asia and the Americas. The number of items in each of the questionnaires in Table 1 varies from 7 ( 12 ) to 100 ( 13 ) items. Several questionnaires have been created for different age groups, including adolescence ( 14 , 15 ), adult ( 16 - 22 ), and old age ( 23 , 24 ). Additionally, certain questionnaires have been developed to assess the sexual health of individuals who have heart disease ( 29 ), uterine prolapse condition ( 30 – 35 ), spinal cord injury ( 27 ), schizophrenia ( 12 , 28 ), cancer ( 5 , 22 , 25 , 26 ), MS ( 10 ), and spinal cord injury. Men ( 23 , 33 ), women ( 11 , 36 , 37 ), both sexes ( 38 ), gay people ( 39 ), health professionals like nursing students ( 17 , 21 ), rehabilitation specialists ( 20 ), health science experts ( 16 ), and menopausal women ( 40 ) have all had questionnaires created for them. The domains examined in the questionnaires are different according to the age group and target groups. In general, all the questionnaires entered in Table 1 reviewed 3 dimensions of sexual health, that is, physical ( 10 , 14 , 16 , 18 , 23 , 25 ), psychological ( 4 , 12 , 26 - 28 ), and social dimensions ( 29 , 30 ). In addition, the level of understanding, knowledge (level of sexual health awareness, sources of information) ( 15 ), attitude and self-efficacy (feeling of comfort, fear of the negative impact of relationships on the future of patients) ( 19 , 20 ) of the individuals were also taken into consideration. The questionnaire's items were scored based on the Likert scale. When the questionnaires are examined more closely, it becomes clear that some were created and tested psychometrically for the first time ( 10 , 11 , 14 , 18 , 19 , 23 , 26 , 36 , 40 ), some were translated and culturally appropriate ( 17 , 20 , 41 , 43 - 46 ), and some were examined for validity and reliability ( 16 , 21 , 31 , 33 , 47 , 48 ). Answering the questionnaires took an average of 24 minutes. In the physical dimension, sexual health conveys the absence of disease and the proper functioning of the reproductive system in all members of society. Norma L. McCoy et al (2000) designed a questionnaire in the United States to measure the main aspects of women's sexuality, especially those that are probably affected by changes in the levels of sex hormones. This 19-item questionnaire with a 4-dimensional Likert scale examines sexual interests, satisfaction with sexual activity, vaginal psychoanalysis, and orgasm. The results of the research suggested that it has good reliability, face validity, content and structure, and good internal consistency ( 11 ). In 2005 in Italy, Alessandra H. Rellini translated McKay's questionnaire and checked its validity. He reviewed sexual interests, satisfaction with frequent sexual activity, and sexual relationship with a sexual partner. This questionnaire was implemented on 240 Italian women aged 18 to 65 years. It has good reliability, with a Cronbach's alpha of 0.88 and 0.75. The results show a difference in the factor structure between the Italian version and the original version of the MFSQ questionnaire ( 31 ). Frances et al (2002) designed a questionnaire to evaluate women's sexual performance. In this 31-item questionnaire with a Likert scale, 7 dimensions of sexual performance of women aged 19 to 65 years were investigated through factor analysis in 7 dimensions of desire, physical and emotional arousal, physical-psychoanalytical arousal, pleasure, orgasm, pain, and sexual partner relationship. The internal consistency of the domains was from 65% to 91% and the test and retest reliability was from 21% to 71%. This questionnaire showed a significant difference between sick and healthy people ( 32 ). The validity of the questionnaire has been investigated in several countries. For instance, in 2006, Afsane Khademi et al investigated the validity and reliability of this questionnaire in Iran ( 33 ). In 2014, in India, Kodakandla Krishna et al investigated the validity of the questionnaire on women's sexual performance,which showed the cutoff point was 87%, the sensitivity 91.7%, and the specificity 86.4% ( 34 ). Montserrat Espuٌa Pons (2009) designed a questionnaire to measure women's uterine prolapse disorder on women's sexual performance and activity. In this questionnaire, 3 dimensions of urinary function, anorectal function, and anatomical defects are examined. It is essential to the diagnosis and management of dysfunction in women. However, sexual activity is not screened by it, and a criterion is required to quantify it ( 35 ). In 2011 in the United States, the validity of the uterine prolapse questionnaire was also investigated and a 12-item questionnaire was designed. This questionnaire examines 3 emotional, behavioral, and physical dimensions as factors associated with the partner ( 36 ). In 2012 in Israel, the validity of the pelvic prolapse questionnaire and sexual function were reviewed. pelvic prolapse, severe pelvic pain, and urinary incontinence are investigated in this 54-item questionnaire ( 37 ). The 12-item Turkish version of glans prolapse or urinary incontinence was also investigated by Dilek Bilgic Celik (2013). It addresses 3 emotional-behavioral, physical, and partner-related dimensions ( 38 ). In 2015, El-Azab investigated the validity of the Arabic version of a 20-item questionnaire. First, the questionnaire was translated and then its validity and reliability were checked. It was divided into 2 large parts. The first part corresponds to women who are not sexually active and includes 4 dimensions related to partner, specific conditions, general quality, and the effect of conditions factors; the second part is relevant to women who are sexually active and includes 6 subscales of arousal or orgasm, partner-related topics, issues of specific conditions, general quality, and effect of conditions and desires ( 39 ). The validity of the 12-item Dutch version of the pelvic prolapse questionnaire with 3 emotional, behavioral, and physical factors related to the partner dimensions was carried out by Hoen in 2015 ( 40 ). The Iranian version of this questionnaire was also conducted by Momeni Movahed ( 6 ). A questionnaire was designed by Marja-Leena Kristofferzon (2010) in Sweden to investigate the sexual performance of cardiac patients. It aimed to address the validity and reliability of the Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among patients with heart problems in 4 subscales of libido, orgasm, arousal, and satisfaction. A total of 79 cardiac patients (47 men and 32 women) completed the questionnaire. The Cronbach's alpha was between 0.48 and 0.86 ( 41 ). In Brazil, Monica Sarto Piccolo (2012) translated the questionnaire on the sexuality of burn victims and then investigated its validity and reliability. This 24-item questionnaire with a Likert scale of body image and social comfort was designed for women and men who were burn survivors to check the quality of their sexual lives. Content, form, and construct validity were reviewed and the overall Cronbach's alpha was 0.87. The Pearson correlation was significant. There was a significant correlation between dimensions of social comfort, body image, ability to perform simple tasks, work, and treatment ( 42 ). Foley et al (2013) shortened the 19-item questionnaire (MSISQ-19) to 15 items. This questionnaire with the Likert scale has 3 primary, secondary, and tertiary dimensions. A total of 6300 MS patients completed the MSISQ-19 questionnaire. It was shortened to 15 items and applied to men and women. The secondary subscale had the highest correlation with disability, and the tertiary subscale had the highest correlation with psychological distress. The Cronbach's alpha indicated good reliability with the overall scale (0.92) and subscales (primary, 0.87; secondary, 0.82; third, 0.91) with a 95% confidence interval of 0.92, which indicated high internal consistency ( 43 ). In another study, Mohammadi et al (2014) translated the original version of this questionnaire into Persian. This 19-item questionnaire with a 3-dimensional Likert scale reviewed primary, secondary, and tertiary sexual dysfunction. The mean age of the participants was 35.77 (SD, 8.07) and the mean duration of the disease was 1.84 years (SD, 0.79). The internal consistency was checked with Cronbach's alpha and it was equal to 0.70. The factor structure was extracted by exploratory factor analysis. The Pearson's correlation coefficient was investigated. KMO test = 0.97 and Bartlett's test results were significant (P < 0.001). The eigenvalue was ˃1 ( 43 ). In England, a questionnaire was designed by Sophie et al (2017). A 22-item questionnaire with a Likert scale was designed for people over 18 years old with a practical purpose for men and women with cancer in different stages of treatment as well as the recovery stage, reflecting sexual health in multiple dimensions. The areas examined are the physical, psychological, and social dimensions of sexual health in 171 women and men with cancer and those who have recovered. The exploratory factor analysis was investigated, accounting for 65.5 of the variances. It shows good internal consistency and the Cronbach's alpha is 0.87 and 0.82. The eigenvalue is ˃1 ( 22 ). Genital and physical diseases or chronic psychiatric disorders impact the quality of intimate relationships, sex life, and satisfaction with sexual relationships of couples. Creating a questionnaire can play a key role in related prevention, identification, and effective interventions. A sexual life quality questionnaire in 2002 by Jean M. B. Woodward et al. was designed in America to evaluate the quality of sexual life and satisfaction with erectile dysfunction treatments among patients and their sexual partners. This Likert scale questionnaire is for women and men with 16 items, 10 of which address aspects of the quality of sexual life and 6 refer to satisfaction with treatment. The scoring is 1-9 and the response time is 8 to 10 minutes. It has well-addressed changes in the quality of sexual life of people and has investigated Cronbach's alpha, validity, reliability, and internal consistency ( 44 ). Davison et al (2008) in England investigated the validity and reliability of Monash women's sexual satisfaction questionnaire. In this 12-item questionnaire with a Likert scale, several dimensions were investigated—including sexual receptivity, readiness of arousal, vaginal lubrication, the level of pleasure associated with the sexual experience, satisfaction with the sexual experience, and achievement of orgasm. The quality and nature of the recent sexual experience of women aged 20 to 65 were also investigated. The findings demonstrated a strong item-to-item correlation and the excellent reliability of the questionnaire. It may accurately distinguish between women who are sexually fulfilled and those who are not ( 28 ). Cappelleri et al (2004) designed the self-esteem and relationship questionnaire in the United States with a 14-item Likert scale designed for men. It aimed to evaluate erectile dysfunction in men with 8 sexual relationship items, 6 self-confidence items, 2 subscales with 4 self-esteem items, and 2 general relationship items. The eigenvalue was ˃1 ( 45 ). Sanders et al (2000) designed a questionnaire in the United States to evaluate the perceived effects of MS symptoms on sexual activity and satisfaction and on the overall quality of intimate relationships, which has been translated into French, Ukrainian, and Farsi. This 19-item questionnaire with a Likert scale has addressed marital satisfaction, especially satisfaction with emotional relationships, problem-solving relationships, sexual dissatisfaction, nervous disorder, level of disability in patients with MS, psychological disturbance and well-being, and overall sexual dysfunction in women diagnosed with MS. The Cronbach's alpha was 0.91 and the internal consistency was very high. The Cronbach's alpha was 0.82 for the 5-item subscale of primary sexual dysfunction, 0.85 for each 9-question subscale of secondary sexual dysfunction, and 0.87 for the 5-question subscale of tertiary dysfunction. All 3 subscales had good internal consistency ( 10 ). Kikuchi (2011) designed a sexual function questionnaire in Japan for severe psychiatric patients with schizophrenia. It has 36 items for men and 36 items for women; the 6 dimensions for men include gynecomastia, increased or decreased sexual desire, erectile, ejaculatory, or orgasmic dysfunction; and 7 dimensions for women include menorrhagia, amenorrhea, galactorrhea, increased or decreased sexual desire, orgasmic dysfunction, and vaginal dryness. The results of Cronbach's alpha analysis indicate excellent internal consistency and reliability. The questionnaire has good convergent validity ( 26 ). In China in 2016, Wang investigated the validity and reliability of the sexual dysfunction questionnaire of patients with schizophrenia. The questionnaire has 7 questions—questions 1 and 2 examine whether the patient has realized changes in sexual function after medication therapy or during the past 4 weeks; questions 3 to 7 refer to sexual desire, delay in orgasm or ejaculation, lack of orgasm or ejaculation, erectile dysfunction in men/vaginal psychoanalysis disorder in women, and disease tolerance of severe mental disorder. The internal consistency of the Chinese version with Cronbach's alpha was 0.902. There are good positive and negative value propositions for sensitivity and specificity ( 12 ). Merghati-Khoei et al (2015) in Iran analyzed the validity of the sexual compatibility questionnaire of a population with spinal cord injury. In this 11-item questionnaire, 4 dimensions of positive motivation, negative motivation, acceptance, and sexual capacity were reviewed. The Cronbach's coefficient and internal correlation coefficient were 0.77 and 0.72, respectively. The exploratory factor analysis revealed the questionnaire's 4-factor structure, which explained 68.9% of the variance, and experts confirmed the face and content validity ( 30 ). Chitra Raghavan (2014) designed a 37-item multidimensional sexual compulsion questionnaire with a Likert scale for students in the United States. It referred to coercion, pressure to have sexual intercourse, exploitation, and compulsory relationships as well as less commonly measured tactics of humiliation and two clusters of tactics pertaining to forced compliance based on past coercion ( 29 ). Marı´a del Mar Sa´nchez-Fuentes from Spain addressed the validity of the interpersonal exchange model questionnaire in 2015. It contained 100 items and a Likert scale. At first, the questionnaire was translated and adapted to the culture of Spain. The study group was women and men and their mixed relationships. Six aspects of sexual reward, an assessment of the reward level in relation to expected rewards, an assessment of the reward level in relation to their partner's reward level, and parallel items for the assessment of sexual costs were all included in the questionnaire. The results indicated that the questionnaire had good psychometric properties and excellent internal consistency. Pre- and posttest reliability was good. The scores of sexual satisfaction, marital compatibility, and sexual performance were correlated, which showed good concurrent and convergent validity ( 13 ). In 2020 in Spain, Cristَbal Calvillo investigated the validity of the same questionnaire for gay people. Sexual function—such as interest, arousal, orgasm, ejaculation (for men only), and overall sexual satisfaction—was assessed in the past month. This questionnaire had good reliability and concurrent and construct validity ( 46 ). The sexual health and sexual well-being of young people were thoroughly defined and amended in a different study carried out in Japan in 2021 by Naomi Sanyika Moore et al. They also created a useful instrument that gave insight into the demands of students. This 21-item survey covers 7 aspects of sexual health resources, relationships pertaining to sexual health, the value and satisfaction of action, attitudes toward sexual pleasure, protection from STDs, preventing unintended pregnancies, and emotional well-being in the area of sexual health. It was intended to use a Likert scale. Between 0.90 and 2.50 was the range of the standard deviation (KMO = 0.806; Bartlett's test (χ2[105] = 2271.2; P < 0.001) ( 18 ).

Researchers, experts in the field of health and sexology, social workers, psychologists and other actors of social harms and sexology are in need of questionnaires to provide quality services and investigate the problems and needs of their target group. Various types of surveys serve various functions. Participation in sexual decision-making, sexual negotiation power, sexual communication skills, sexual experiences and their impact on the quality of sexual life, knowledge and use of contraceptive methods, HIV/AIDS, and sexually transmitted infections are the primary indicators that are analyzed in the questionnaires. Because of their cultural compatibility with certain nations, a number of questionnaires have been translated or culturally modified, and their validity and reliability have been assessed. This set of indicators can be methodically completed in any study based on the idea of promoting sexual health; however, native questionnaires with cultural sensitivities should use additional indicators that consider the sociocultural determinants of each society with sexual values and norms of the same cultural background. This study has been approved by the ethics committee of the University of Social Welfare and Rehabilitation Sciences with the ethical code of IR.USWR.REC.1400.149 and the ethical principles have been fully observed in this article.

The present scoping review was conducted to assess the scope of sexual health questionnaires and the general characteristics and specific characteristics (dimensions and psychometric properties) of each questionnaire. According to the research question, the results obtained from the questionnaires were categorized into 3 general categories as follows: physical, psychological, and social. The questionnaires have been designed for different ages and both sexes, particularly women. The highest number of items was 100 ( 12 ) and the lowest was 5 ( 47 ). Most of the questionnaires were designed in the United States ( 10 , 11 , 23 , 32 , 36 , 44 , 45 , 48 ). Although numerous studies have been conducted on designing and assessing psychometric properties of sexual health questionnaires or sexual health-related concepts, no review assesses all sexual health questionnaires at once. Several studies were identified by evaluating review studies, particularly a scoping review of the field of sexual health. A study was conducted with an integrated review method to investigate the available instruments for assessing the sexuality of Brazilians. In this study, the psychometric properties of sexual performance, sexual behavior, and sexual satisfaction questionnaires, and also the clinically available measures of sexuality among Brazilian people were reviewed. The results reveal the presence of 18 scales and questionnaires appropriate to the Brazilian culture and in the Brazilian-Portuguese language, covering sexual disorders and clinical measures ( 49 ). This review has been conducted in an integrated manner, only investigating 3 concepts of sexual health. The common point of this review article and the present study is assessing the psychometric properties of the instruments. Questionnaires pertaining to sexual agreement in sexual partners were the subject of another scoping review. A literature review on the idea of sexual agreements was conducted for this review. The findings highlight the research gap in this area and have addressed the tools available in this subject ( 50 ). Like previous studies, this one looks at just one concept. The sexual health and well-being tools used by women enduring female genital mutilation or cutting were the subject of a scoping review in another study. This study evaluated the validity and reliability of 18 studies on the instruments pertaining to the sexual health and sexual well-being of women enduring female genital mutilation or cutting using a checklist consisting of 18 items. One important aspect of the tools is that they are culture-oriented. This scoping investigation has observed that all of the articles are focused on culture. Furthermore, this scoping review addresses a different facet and concept of sexual health, which is not consistent with the objectives of our study. Although the current scoping review focuses on sexual health surveys, this study has assessed sexual well-being ( 51 ). A rapid review was conducted to check the quality and measurement properties of sexual health knowledge tools for adolescents. In this study, the validity and reliability of the studies were assessed, the amount of interpretability and responsiveness of the studies regarding the quality and measurement properties of sexual health knowledge tools were investigated, and it was found that some studies had ignored the validity ( 52 ). Regarding methodology, one study additionally examined the validity and reliability of research as well as psychometric properties. The objectives of the current study differ from those of the conducted research in 2 areas: the assessment of instruments and sexual knowledge. A systematic review was conducted on how to improve the validity of sexual behavior tools in developing countries ( 53 ). Another systematic review investigated questionnaires designed in Spain to evaluate pelvic floor dysfunctions in women. In this questionnaire, the structural and psychometric properties of the questionnaires were addressed ( 54 ). Another study also assessed women’s sexual performance indices. In this study, the indices related to the sexual performance of only women and also the psychometric properties of the questionnaires have been investigated ( 55 ). A scoping review was conducted to examine the health and quality of life. In this study, the general characteristics of the articles, such as journals, method, year of publication, and country, but not the psychometric characteristics of the articles, were assessed . Thus, it can be claimed that the reviews that were conducted have several characteristics, including concepts related to sexual health, an analysis of one of the concepts of sexual health, as well as for a particular sex, such as women, and consideration of the concepts of sexual health in a particular nation or evaluating tool, checklist, instrument, or scale. The current scoping review offers information on a number of sexual health surveys for men and women in the adolescent to middle-aged age range, as well as a group of patients. Every questionnaire's addressed dimensions and psychometric qualities have been examined. The results of this scoping review highlight the research gap in the literature and point readers to the dearth of questionnaires in other sexual health dimensions as well as in other countries. They also highlight the psychometric qualities of the questionnaires and their disregard for the cultural context of countries. Researchers can easily and conveniently access a variety of questionnaire types by reading this review. They can then use the combined approach to create a new questionnaire and use the items from these questionnaires in their research based on their culture. Although sexual health has been examined from a variety of perspectives in the available questionnaires included in the results table, the spiritual aspect of sexual health has not been disregarded; in fact, it may be argued that the physical and mental aspects of sexual health have received more evaluations than the social aspect. Additionally, there is no instrument or questionnaire to evaluate the sexual health of patients' spouses or even healthy people. It might be argued that a person's sexual health is influenced by mental, social, cultural, familial, religious, and spiritual elements; these factors should also be considered in the questionnaires. One of the drawbacks of this study is that it only searched 4 databases; other databases could not be searched because of penalties and restricted access. Only articles written in English were examined in these databases. It is recommended that future research evaluate publications in other languages and databases, if at all possible.

Health has a wide concept and its definition is influenced by the level of understanding and perception of societies and various geographical and cultural situations, besides the fact that health is a dynamic process and its concept will change in the process of time. One of the dimensions that the World Health Organization (WHO) recently paid attention to is the sexual aspect of health ( 1 ). Sexual health and well-being are the main core of overall health and well-being, and maintaining and improving them lead to obtaining the highest standards of physical and mental health, as well as achieving overall health ( 2 , 3 ). On the other hand, the lack of attention to sexual health and physical diseases affects people's quality of life. Research results indicate that 40% to 75% of patients with multiple sclerosis (MS) in the age group of 20 to 40 years have sexual disorder, which affects their quality of life ( 4 ) or breast cancer is the cause of sexual dysfunction. Breast surgery affects the body image, self-esteem, and sexual activity of patients ( 5 ). Disorders in the pelvic floor, such as urinary incontinence (UI) and pelvic organ prolapse, have an adverse effect on sexual function and quality of life. UI is associated with low libido, vaginal dryness, and dyspareunia, and many women avoid sexual intercourse due to fear or shame of incontinence during intercourse ( 6 ). In the adolescent age group, another study suggests that about 20% of unwanted pregnancies in Asia, and about 50% in Latin America, the Caribbean, and Africa end in unsafe abortion ( 7 ), which have a negative impact on the health of adolescents. Erectile disorder also increases in men with age increase, and the understanding of menopause and treatment in women can affect the quality of sexual health and sexual partner satisfaction ( 8 ). Given that the concept of sexual health is relative and abstract and is influenced by the cultural-social context and structure, considering the increase in social harms and the relationship between sexual health and public health and its impact on other dimensions of health, it is necessary to provide a basis for improving satisfaction with marital life, quality of sexual life, sexual compatibility, sexual pleasure, and sexual well-being by designing a questionnaire. Planning sexual health education requires planning, designing, and evaluating intervention programs for prevention, examining the efficacy of programs, reducing social harm, preventing high-risk sexual behaviors like STDs and infections, unsafe abortion, early pregnancy, and delaying the first sexual encounter, and providing the foundation for sustaining and advancing the sexual health of individuals of all ages as well as for effective participation and presence in society to be on the path of individual and community development. This study aimed to review the range of questionnaires in the field of sexual health and to respond to the research questions as to what sexual health questionnaires are available and what concepts and dimensions they cover.

The authors declare that they have no competing interests.