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Assessment of Sexual Health in Aging Men in Europe: Development and Validation of the European Male Ageing Study Sexual Function Questionnaire


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    The EMAS study group: Florence (Gianni Forti, Luisa Petrone, and Antonio Cilotti); Glasgow (Mike Lean and Thang Han); Leuven (Dirk Vanderschueren, Steven Boonen, and Herman Borghs); Lodz (Krzysztof Kula, Jolanta Slowikowska-Hilczer, and Renata Walczak-Jedrzejowska); London (Ilpo Huhtaniemi); Malmö (Aleksander Giwercman); Manchester (Frederick Wu, Alan Silman, Terence O'Neill, Joseph Finn, Philip Steer, Abdelouahid Tajar, David Lee, and Stephen Pye); Santiago (Felipe Casanueva, Marta Ocampo, and Mary Lage); Szeged (George Bartfai, Imre Földesi, and Imre Fejes); Tartu (Margus Punab and Paul Korrovitz); and Turku (Min Jiang).

Daryl B. O'Connor, PhD, Institute of Psychological Sciences, University of Leeds, Leeds, UK. Tel: +44 (0) 113 343 5727; Fax: +44 (0) 113 343 5749; E-mail: d.b.o?


Introduction.  Assessment of male sexual dysfunction has been the focus of substantial scientific effort. Less research has focused on the development of instruments for the measurement of sexual functioning in aging men.

Aims.  The aims of this study were: (i) to characterize the psychometric properties of a new brief, reliable, and valid measure of male sexual functioning for use in a large population survey of middle-aged and elderly European men; and (ii) specifically, to determine whether the new instrument, the European Male Ageing Study–sexual function questionnaire (EMAS–SFQ), discriminates between men with high and low levels of circulating testosterone (T) (total T, free T, and bioavailable T).

Method.  One thousand six hundred men aged 40–79 years completed the self-administered EMAS–SFQ, the Beck depression inventory, and provided a blood sample for assessment of sex hormones. Eighty-five men aged 35–74 years completed the EMAS–SFQ twice, 2 weeks apart to examine the test–retest reliability of the instrument.

Main Outcome Measures.  Scores on the EMAS–SFQ in relation to age and T levels.

Results.  Principal component analysis showed that the EMAS–SFQ had four distinct domains (overall sexual functioning [OSF], masturbation, sexual functioning-related distress, and change in sexual functioning). The instrument demonstrated excellent internal and test–retest reliability, as well as convergent, divergent, and discriminant validity. Men with the lowest levels of total, free, and bioavailable T reported lower OSF scores compared to men with the highest T levels.

Conclusions.  The EMAS–SFQ is a valid and reproducible instrument, sensitive to age and T levels. It should be suitable for the assessment of sexual health in population samples of men in epidemiological studies of aging. O'Connor DB, Corona G, Forti G, Tajar A, Lee DM, Finn JD, Bartfai G, Boonen S, Casanueva FF, Giwercman A, Huhtaniemi IT, Kula K, O'Neill TW, Pendleton N, Punab M, Silman AJ, Vanderschueren D, Wu FCW, and the European Male Ageing Study group. Assessment of sexual health in aging men in Europe: Development and validation of the European Male Ageing Study sexual function questionnaire. J Sex Med 2008;5:1374–1385.