A panel of experts formulated relevant domains of sexual function with a focus on sexual interest and desire. The resulting 10-item scale, the Menopausal Sexual Interest Questionnaire (MSIQ), was examined for reliability (internal consistency and test-retest repeatability), construct validity (concurrent, convergent, and discriminant), sensitivity, and specificity in a clinical trial. A principal components analysis identified three factors (desire, responsiveness, and satisfaction) with eigenvalues > 1. A high degree of internal consistency was observed for each of the three domains. Test-retest repeatability correlation coefficients for domain scores were all highly significant. The MSIQ demonstrated adequate construct validity, with all three domains showing a high degree of sensitivity and with two of the three exhibiting specificity to the effects of treatment.