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Tell Us About Your Romantic Life
1.
What's your relationship status at the moment?
Married
Single (Never Married)
Single (Divorced)
Single (Widowed)
In a Committed Partnership
Other (please specify)
2.
If you're single are you:
Happily dating
Unhappily dating
Done with dating
Happily not dating
3.
Are you attracted to:
Men
Women
Either
Neither
4.
If you're single (or were single in the past 10 years), have you used an online dating service? Leave blank if not applicable.
Yes
No
5.
Which dating services have you used (check all that apply)? Skip if not applicable.
Match.com
E-Harmony
Bumble
Tinder
Our Time
Silver Singles
OK Cupid
BlackPeopleMeet
Elite Singles
Zoosk
ChristianMingle
JDate
Other (please specify)
6.
Which dating service was best for you and why? Skip if not applicable.
7.
If you're single (or were single in the past 10 years), have you used a personal matchmaking service (NOT online dating)? Skip if not applicable.
Yes
No
8.
How often do you have sex?
Almost everyday
A couple of times per week
A few times a month
Every few months
Can't remember
Not in years
Other (please specify)
9.
Who usually initiates sex?
Me
My partner
Pretty evenly split
Not applicable
10.
Have you used sex toys, such as vibrators or dildos, in the past five years?
Yes
No
11.
Do you use lubrication during sex?
Yes
No
12.
Which of the following have you experienced in the past five years? Check all that apply.
Vaginal dryness
Painful sex
Lack of desire
Inability to orgasm
None of the above.
Other (please specify)
13.
Which of the following are regular parts of your sexual activities? Check all that apply.
Receiving oral sex
Giving oral sex
Sex toys
Role playing
Anal sex
None of the above
Other (please specify)
14.
Do you usually have an orgasm during sex?
Yes
No
15.
How does your desire compare to five years ago?
I have more desire
I have less desire
I have about the same amount of desire
16.
As far as sex, would you like to have:
More sex
Less sex
Happy with how much sex I'm having
17.
Has your partner had erectile dysfunction often enough to be an issue in your sex life?
Yes
No
18.
If your partner has had erectile dysfunction, which of the following treatments has he tried? Check all that apply.
Viagra
Cialis
Levitra
Staxyn
Vacuum Constriction Device (or penis pump)
ED Surgery
Counseling
Alternative Remedies, such as herbs, supplements and acupuncture
Testosterone therapy
No treatment sought
Other (please specify)
19.
How often do you masturbate?
Never
Rarely
Sometimes
Often
Almost every day if I can manage it
20.
What is most likely to get you in the mood for sex? Check all that apply.
Kissing and petting
Watching a sexy movie or TV show
Reading a sexy passage in a book
Watching soft porn
Watching hard porn
Partner making sexy comments
Thinking of good sex in the past
Oral sex (receiving)
Oral sex (giving)
Alcohol
Romantic date
Seeing him do housework
Other (please specify)
21.
If there were a Viagra-like pill to increase your desire, would you take it?
Yes
No
22.
What questions do you have about love and sex at this age? Or what more do you want to tell us about your romantic life?