As suggested ‘sexuality and reproductive capacity are fundamental aspects of being human. Our sexual and reproductive health and well being is as important to our quality of life as other key aspects of health such as physical and mental health and well being’ . This study reported the psychometric properties of the Sexual Quality of Life-Female among a women population in Iran. Overall the results showed that the questionnaire is a valid and reliable instrument for evaluation of female sexual quality of life. The Cronbach’s alpha coefficient and intraclass correlation coefficient were acceptable and indicated good reliability and stability for the questionnaire. In addition, the CVI and the CVR indicated a reasonable content validity.
Validity of the SQOL-F questionnaire first was assessed in the UK and the USA. In the UK setting studying a sample of 1296 women aged 18–65 years, internal consistency was found to be 0.95 and the questionnaire discriminated well between depressed and not depressed women. Also, factor analysis showed that the questionnaire was a unidimensional construct because there was no obviously split of factor loadings . In the USA setting studying three groups of women (women with spinal cord injury, women with sexual dysfunction and a sample of healthy women), the SQOL-F was lower among women with sexual dysfunction as expected lending support to its discriminate validity. In addition, intraclass correlation coefficient was reported to be 0.85, which showed an appropriate stability for the questionnaire . A recent publication even confirmed that the SQOL-F showed a good convergent validity with the 28-item Sexual Function Questionnaire (SFQ28) .
The current study indicated a four-factor solution for the Iranian version of the SQOL-F, while the original questionnaire represents a unidimensional construct . The four factors that we found were: 1. Psychosexual Feelings representing women’s feelings related to sexual experiences. 2. Sexual and Relationship Satisfaction indicating the concept of quantity and quality of sexual relationship and also, positive feelings about oneself and interpersonal relationship such as closeness. 3. Self-Worthlessness construct assessing negative feelings such as losing confidence and feeling of guilt. 4. Sexual Repression measuring loss of pleasure, embarrassment, and avoiding sexual activity. There might be several explanations for such different findings. For instance one might argue that different socio-cultural conditions might led women to respond differently to sexuality issues and thus difference on factor structure of the questionnaire in Iran and the UK in fact relates to women’s perspectives on sexuality and femininity. In Iran after a certain age most women should marry and thus sexual relationship outside of marriage is prohibited while in western culture a woman could remain single and thus having several sex partners might be allowed. In addition in countries such as Iran talking about sexual relationship or sexual problems by a woman might be seemed as rudeness while in western culture most women usually speak about these issues at ease. Another explanation for such observations might be related to labeling choice for the domains. For example the domains that built into the measure by the original developers are confidence, emotional impact and relationships and these are very similar in concept with worthlessness, psychosexual feelings, and relationship satisfaction, respectively. However, for determining definitive difference between constructs of the Iranian version and original scale of the SQOL-F, conducting the known-groups comparison, convergent validity and sensitivity analysis are suggested.
In general the sexual quality of life among the study sample was found to be acceptable. Yet, it seems that ‘Sexual Repression’ was low reflecting the need for further consideration in studying sexual quality of life among Iranian women. Finally, we think reporting overall sexual quality of life score instead of reporting each subscale would be better. Although scores for subscales could help to identify the area of concern in sexual relationship but since subscales are derived from the current study they could not be generalized. Similarly the instrument developers suggested that all inherent concepts of the instrument are heavily interrelated and should be assessed in an overall total score rather than as separate domains .
This study had some limitations. Firstly, the age range of women who participated is this study left within the reproductive period and pregnant and postmenopausal women were excluded. This restricted age period can be considered as one limitation. However, the reason for this sampling bias was due to the presence of a definitive difference among sexual status during reproductive ages, pregnancy and post menopause in Iranian women [21–24]. Secondly, a major limitation of our research is that we have not tested convergent or known-groups validity. However, the original validation study showed that the SQOL-F to have strong convergent and known-groups validity  and we would expect the same for the Persian version, especially given the solid results given above.
In conclusion the findings from this study indicated that the Iranian version of the SQOL-F questionnaire is a reliable and valid instrument for measuring female sexual quality of life.