There is a sad lack of consensus and systematization for analyzing the type, background and consequences of female and male sexual dysfunctions. Moreover many questionnaires appear somewhat conceptually confusing, aggregating etiologies, dysfunctions per se and their consequences into scores. This presentation focuses upon a model for the differential diagnosis of sexual dysfunctions.

The ability to act intentionally to reach sexual goals is contextually dependent in terms of bodily function/impairment and psycho-socio-cultural adaptation to circumstances.

Maladaptation is perhaps the most common etiology underlying several dysfunctions.

The action level should describe and quantify the sexual function/dysfunction per se including the duration of the dysfunction. This may be quite difficult due to lack of stringent definitions.

The statement level addresses the extent to which the person believes that she can reach her goals of sexual activities. An aspiration/achievement gap may (but not necessarily so) lead to intrapersonal problems (distrees/bother) which for the clinician is a major point for each dysfunction. Proper identification and quantification of these experiences in relation to contextual factors are necessary. Here it should be noted that distress/bother is generally less pronounced than is dysfunction per se.

Finally, at the emotion level the sexual satisfaction level must be analyzed and related not only to the distress/bother level of each dysfunction, but also to satisfaction with other domains of life.

It should be added that when dealing with sexual dysfunctions, the sequence of levels is not unidirectional.

A proper sexological diagnosis demands a meticulous pluri-facetted analysis in order to establish adequate treatment.