Brief Sexual Function Inventory (BSFI) Test

Evaluates whether the male sexual function is affected by symptoms of the lower urinary tract (LUTS).

Read more about the criteria in the inventory and about LUTS in the text below the calculator.

The Brief Sexual Function Inventory (BSFI) test assesses if the male sexual function has been affected by symptoms that pertain to a lower urinary tract condition.

This is a clinician administered questionnaire which consists of 5 sexual functional domains and the observations refer to the last four weeks in the patient’s life.

Each of the 11 items in the BSFI is evaluated on a Likert scale (points from 0 to 4), therefore the score varies between 1 (because first item starts from 1 point) and 45.

The result introduces the final score and the scores obtained in each of the 5 functional domains.

There is no specific cut-off, thus the interpretation is left at clinical judgment, however, the lower the score, the higher the LUTS symptom severity and impairment to sexual function.


During the past 30 days, on how many days have you felt sexual drive?


During the past 30 days, how would you rate your level of sexual drive?


Over the past 30 days, how often have you had partial or full sexual erections when you were sexually stimulated in any way?


Over the past 30 days, how often have you had erections; how often were they firm enough to have sexual intercourse?


How much difficulty did you have getting an erection during the last 30 days?


Over the past 30 days how much difficulty have you had in ejaculating when you have been sexually stimulated?


In the past 30 days, how much did you consider the amount of semen you ejaculate?


In the past 30 days, to what extent have you considered a lack of sex drive to be a problem?


In the past 30 days, to what extent have you considered your ability to get and keep an erection a problem?


In the past 30 days, to what extent have you considered your ejaculation to be a problem?


Overall during the past 30 days, how satisfied have you been with your sex life?

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BSFI explained

The BSFI helps evaluate male sexual dysfunction in the light of symptoms pertaining to conditions of the lower urinary tract.

The original study recommends to the patient to think of his experiences for the past month and is preceded by this indication: “Lets define sexual drive as a feeling that may include wanting to have a sexual experience (masturbation or intercourse) thinking about having sex or felling frustrated due to lack of sex.”

The BSFI consists of 11 items divided in 5 functional domains, as described in the table below:

BSFI functional domain BSFI items description
Sexual drive 1. Frequency of experiencing sexual drive;
2. Rating the level of sexual drive;
Erections score 3. Frequency of partial or full sexual erections during stimulation;
4. Frequency of the ability to have sexual intercourse (firm erections);
5. Difficulty in obtaining an erection;
Ejaculation score 6. Degree of difficulty ejaculating while being sexually stimulated;
7. Considering the amount of semen ejaculated;
Problem assessment score 8. To what extent is lack of sex drive considered to be a problem;
9. To what extent is the ability to keep an erection a problem;
10. To what extent ejaculation is considered a problem;
Overall satisfaction score 11. Overall satisfaction with sexual life for past 30 days.

The questions in the BSFI are evaluated on a series of 5-item Likert scales, from 0 or 1 points to 4 or 5 points. Scores are calculated for each of the 5 functional domains, along with a total BSFI score.

Whilst there is no specific cut-off, the closer the score is to 1, the higher the LUTS symptom severity and impairment to sexual function.

Scores closer to 45 are considered to indicate less severe symptoms and little to no sexual dysfunction.

In 1995, O'Leary et al. created the BSFI as a clinician reported questionnaire (to be administered in 5 to 10 minutes).

The initial set of questions went through cognitive testing and two serial validation studies. During the study, test-retest reliabilities, internal consistencies, and construct validities were assessed.

BSFI psychometric performance was rated as satisfactory.

Limitations of the model revolve around the self-assessment of ejaculate volume which is not deemed objective enough and the fact that the overall satisfaction domain is less associated with age, whilst the other four domains are.

The BSFI was used along the International Prostate Symptom Score (IPSS) in a study on a population of men with benign prostatic hyperplasia (BPH) who also experienced lower urinary tract symptoms.


LUTS guidelines

Lower tract urinary symptoms, also known as prostatism, is a group of symptoms, known to mainly affect older men. There are two types of symptoms:

■ The filling or irritative symptoms;

■ The voiding or obstructive symptoms.

Some of the LUTS include: increased frequency and/or urgency of urination, incomplete voiding, painful urination or poor stream.

LUTS it is caused by:

■ Urinary tract infections;

■ Benign prostatic hyperplasia;

■ Chronic prostatitis;

■ Urinary stones;

■ Bladder or prostate malignancy.

Laboratory PSA (prostate specific antigen), urinalysis and ultrasound are the most common diagnosis methods. These are often combined with scores such as the IPSS.

In the serious cases, therapy is initiated with alpha-1 blockade and anti-androgen medication or surgery may be recommended.

Less serious cases, may be able to make certain lifestyle changes to decrease the level of discomfort, such as changing voiding position.


Original source

O'Leary MP, Fowler FJ, Lenderking WR, Barber B, Sagnier PP, Guess HA, Barry MJ. A brief male sexual function inventory for urology. Urology. 1995; 46(5):697-706.

Other references

1. Mykletun A, Dahl AA, O'Leary MP, Fosså SD. Assessment of male sexual function by the Brief Sexual Function Inventory. BJU Int. 2006; 97(2):316-23.

2. Shao Q, Song J, Guo YW, Lu WC, Du LD. Evaluation of sexual function in men with symptomatic benign prostatic hyperplasia. Zhonghua Nan Ke Xue. 2005; 11(7):505-7.

Specialty: Urology

System: Urinary

Objective: Evaluation

Type: Inventory Test

No. Of Items: 11

Year Of Study: 1995

Abbreviation: BSFI

Article By: Denise Nedea

Published On: May 29, 2017 · 07:42 AM

Last Checked: May 29, 2017

Next Review: May 29, 2023