Diagnosing Sexual Dysfunction in Men and Women: Sexual History Taking and the Role of Symptom Scales and Questionnaires Dimitris Hatzichristou, MD, PhD, 1 Paraskevi-Sofia Kirana, PhD, 2 Linda Banner, PhD, 3 Stanley E. Althof, PhD, 4 Risa A. M. Lonnee-Hoffmann, MD, PhD, 5 Lorraine Dennerstein, MD, PhD, 6 and Raymond C. Rosen, PhD 7 ABSTRACT Introduction: A detailed sexual history is the cornerstone for all sexual problem assessments and sexual dysfunction diagnoses. Diagnostic evaluation is based on an in-depth sexual history, including sexual and gender identity and orientation, sexual activity and function, current level of sexual function, overall health and comorbidities, partner relationship and interpersonal factors, and the role of cultural and personal expectations and attitudes. Aim: To propose key steps in the diagnostic evaluation of sexual dysfunctions, with special focus on the use of symptom scales and questionnaires. Methods: Critical assessment of the current literature by the International Consultation on Sexual Medicine committee. Main Outcome Measures: A revised algorithm for the management of sexual dysfunctions, level of evidence, and recommendation for scales and questionnaires. Results: The International Consultation on Sexual Medicine proposes an updated algorithm for diagnostic evaluation of sexual dysfunction in men and women, with specific recommendations for sexual history taking and diagnostic evaluation. Standardized scales, checklists, and validated questionnaires are additional adjuncts that should be used routinely in sexual problem evaluation. Scales developed for specific patient groups are included. Results of this evaluation are presented with recommendations for clinical and research uses. Conclusion: Defined principles, an algorithm and a range of scales may provide coherent and evidence based management for sexual dysfunctions. J Sex Med 2016;13:1166e1182. Copyright Ó 2016, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved. Key Words: Scales; Questionnaires; Diagnosis; Sexual History; Algorithm INTRODUCTION Committee 3 of the International Consultation on Sexual Medicine (ICSM) reviewed a large body of relevant publications on the diagnostic evaluation of sexual function in men and women, including advances in specialized testing for women and men and the development of scales and questionnaires for evaluating sexual dysfunction (SD) in women and men. We report the findings and recommendations of the committee for the overall diagnostic approach and assessment algorithm for evaluation of male and female SDs and the use of symptom scales and questionnaires in particular to assist in the evaluation. The committee also consid- ered current scientific and regulatory requirements for the devel- opment and validation of patient-reported outcomes (PROs) and cultural and clinical considerations when using these assessments. PART 1. DIAGNOSTIC EVALUATION OF SDS IN MEN AND WOMEN Principles of Sexual Medicine The committee endorses three basic principles for clinical evaluation and management of sexual problems in men and women. These are briefly as follows: Received March 29, 2016. Accepted May 13, 2016. 1 Institute for the Study of Urological Disease and Department of Urology, Aristotle University, Thessaloniki, Greece; 2 Department of Sexual and Reproductive Health, Institute for the Study of Urological Disease and Private Practice, Thessaloniki, Greece; 3 Private Practice, San Jose, CA, USA; 4 Center for Marital and Sexual Health of South Florida,West Palm Beach, FL; Case Western Reserve University School of Medicine, Cleveland, OH, USA; 5 Institute of Laboratory Medicine, Women’ s and Children’ s Health, Norwegian University of Science and Technology and Gynecological Department, St. Olavs Hospital, Trondheim, Norway; 6 Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; 7 New England Research Institutes, Watertown, MA, USA Copyright ª 2016, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jsxm.2016.05.017 1166 J Sex Med 2016;13:1166e1182