Questionnaire
M.
These Questions Are About Satisfaction and the Frequency and Quality
of Various Kinds of Touching Activities.
N. Questions about Sexuality and Menstrual Cycles.
1. I have been satisfied with my sex life
(including self-sexual activity) in the last 3 months.
Strongly Disagree Strongly Agree N/A
|
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
0 |
If you have not engaged in
sexual activity
(of any kind) with a partner in
the last 3 months, please circle 0 and skip to Question 6 of this
section.-
2. I have been satisfied with my sex life with a partner in the
last 3 months.
Strongly Disagree Strongly Agree N/A
|
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
0 |
3a. In the last 3 months, I have been
satisfied with the quality of genital stimulation and/or intercourse
I've had with a partner.
Strongly Disagree Strongly Agree N/A
|
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
0 |
3b. With respect to the frequency of this
kind of activity, I would like:
|
More
|
Less
|
About the same amount
|
4a. In the last 3 months,
I have been satisfied with the quality of sexual/erotic contact I've
had with a
partner that did not include or lead to sustained genital
stimulation or intercourse (For example, a
passionate kiss or erotic
caress).
Strongly Disagree Strongly Agree N/A
|
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
0 |
4b. With respect to the
frequency of this kind of activity"
|
More
|
Less
|
About the same amount
|
5a. In the last 3 months,
I have been satisfied with the quality of the affectionate nonsexual, nongenital
touching I've had with a partner.
Strongly Disagree Strongly Agree N/A
|
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
0 |
5b. With respect to the frequency
of this kind of activity, I would like:
6a. Regarding total amount
of sexual activity (anything and everything sexual)in my current or
most recent relationship:
| |
I want (wanted) more than
my partner |
| |
My partner wants (wanted)
more |
| |
My partner and I want(wanted)
about the same amount. |
| |
If you want (wanted) about
the same amount, skip 6b. |
6b. We (have) reached
a mutually satisfying compromise.
Strongly Disagree Strongly Agree N/A
|
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
0 |
N. The Next Questions are about
Sexuality and Your Menstrual Cycle
1. It seems to me that my sexual desire has (had) predictable
variations due to my menstrual cycle.
Strongly Disagree Strongly Agree N/A
|
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
0 |
2. It seems to me that my sexual satisfaction has
(had) predictable variations due to my menstrual cycle.
Strongly Disagree Strongly Agree N/A
|
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
0 |
3. I enjoy(wanted) sexual activity during my menstrual flow.
Strongly Disagree Strongly Agree N/A
|
| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
0 |
4. I engage(d) in sexual intercourse during my
menstrual flow.
|
Never
|
Rarely
|
Sometimes
|
Often
|
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Remember
The questionnaire is here for VIEWING ONLY.
Please DO NOT send your answers to me.
Copyright 1998, Carol Ellison, Ph.D.
