Background Delays in health seeking, non adherence, and an increase of patients coping with their sexual problems outside the formal health system increase concerns that people's sexual health needs have not been adequately understood by health providers. In trying to understand the above phenomenon, most researchers have used a biomedical point of view, which in this case, has been able to explain very little. Unfortunately data are lacking in the literature exploring the selfperception of SD and help-seeking behaviour through a bio-psycho-social point of view. In order to bridge the knowledge gap on the above domain, a) a bio-psychosocial conceptual framework explaining people's response to symptoms was developed, and b) this was initially tested in a random sample of patients attending a general hospital. Aim The overall aim of the proposed research is to provide data on factors that determine peoples’response to symptoms suggestive of sexual dysfunction (SD), through a bio-psychosocial conceptual framework. The research aims to describe a) the experience of a symptom of SD by gender, and b) psychosocial factors that determine the help-seeking behaviour. Methods HOPES is a hospital based survey investigating the relationship between psychosocial factors, patient centeredness, symptoms’and health perception in a random sample of patients attending a general hospital. The design included a representative cross section of each clinic and equal numbers of subjects in each of 6 design cells, defined by age (18-40, 41-60, 61-80 years) and gender Sexual functioning was measured by SCSF, bother by a single question, while psychosocial factors by 28 instruments categorized as: 1) personality characteristics 2) self beliefs, 3) health beliefs, 4) social support, 5) lifestyle, 6) subjective wellbeing, and demographics. Results 52% of men and 67% of women reported at least one sexual problem (SP). However, only 28% of men and 31.4% of women reported being dissatisfied with their sexual functioning. Dissatisfaction with sexual functioning was significantly associated with age in both genders. Within men, the 61-80 age group reported dissatisfaction most frequently (45%), but within women, it was the 41-60 age group (43%). Reduced sexual desire and premature ejaculation were the most bothersome SPs reported by men being satisfied with their sexual function, but among those being dissatisfied the most bothersome was erectile dysfunction (ED). Unlike men, the SP that was most bothersome for both satisfied and dissatisfied women was reduced sexual desire. Only 28% of men and 22% of women with at least one SP had sought care from a doctor. However, 55% of men and 40% of women were willing to speak to a doctor about their SP. Treatment seeking was significantly associated with ED in men, and reduced sexual desire in women. Among all the psychosocial variables measured, treatment seeking for SP was mostly associated with increased relationship satisfaction, sense of coherence, general life satisfaction and good perceived physical health in both genders. Conclusion Although sexual problems are highly prevalent, this does not always cause dissatisfaction. Certain sexual problems are more bothersome than others. Approximately half of those reporting a problem want to speak to a doctor, but only have of them have actually done so. While studies on treatment seeking for SP have mostly been limited on the effects of biological factors, this is the only study to date that attempts to reveal the psychosocial resources that explain treatment seeking.