Female Sexual Function Index (FSFI) Questionnaire

FSFI questionnaire

The FSFI was created as a mean to evaluate sexual functioning in women and comprises of 19 questions with different answer choice scales, all inviting the subject to refer to the context of their sexual life in the previous 4 weeks.

The questions are listed as follows:

1. How often did you feel sexual desire or interest?

2. How would you rate your level (degree) of sexual desire or interest?

3. How often did you feel sexually aroused ("turned on") during sexual activity or intercourse?

4. How would you rate your level of sexual arousal ("turn on") during sexual activity or intercourse?

5. How confident were you about becoming sexually aroused during sexual activity or intercourse?

6. How often have you been satisfied with your arousal (excitement) during sexual activity or intercourse?

7. How often did you become lubricated ("wet") during sexual activity or intercourse?

8. How difficult was it to become lubricated ("wet") during sexual activity or intercourse?

9. How often did you maintain your lubrication ("wetness") until completion of sexual activity or intercourse?

10. How difficult was it to maintain your lubrication ("wetness") until completion of sexual activity or intercourse?

11. When you had sexual stimulation or intercourse, how often did you reach orgasm (climax)?

12. When you had sexual stimulation or intercourse, how difficult was it for you to reach orgasm (climax)?

13. How satisfied were you with your ability to reach orgasm (climax) during sexual activity or intercourse?

14. How satisfied have you been with the amount of emotional closeness during sexual activity between you and your partner?

15. How satisfied have you been with your sexual relationship with your partner?

16. How satisfied have you been with your overall sexual life?

17. How often did you experience discomfort or pain during vaginal penetration?

18. How often did you experience discomfort or pain following vaginal penetration?

19. How would you rate your level (degree) of discomfort or pain during or following vaginal penetration?

This table introduces the six domains of the FSFI, their description and corresponding questions:

It is important to note that the FSFI is not meant to substitute diagnostic tools and is not advised to be used for collection of sexual history.

FSFI score interpretation

The answer choices in the FSFI carry a number of points and are summed to obtain six domain scores and an overall score.

For the latter, there is a threshold at 26.55 which means tFhat all values below are classed as indicating female sexual dysfunction (FSD).

The domain scores are obtained as the sum of points attributed to questions in that domain multiplied by the domain factor.

The following table describes the six domains, their corresponding questions and possible score range, as well as the domain factor.

Female sexual dysfunction

The FSFI contributes to the search for causes of female dysfunction and in some cases, this is followed up by counselling or hormone therapy.

FSAD is a syndrome characterized by the persistent and recurrent inability to attain or maintain arousal during intercourse. Lack of sexual drive may be triggered by stressful periods of time, by pregnancy or by psychological or physical illness.

Dyspareunia is defined as pain during intercourse caused by low estrogen levels, dryness of the vagina or spasm of the vaginal muscles which in turn are caused by psychological and physical factors.

Orgasm problems are primary or secondary in nature, where primary problems concern the inability to attain orgasms while secondary problems concern the loss of ability to attain orgasms.

About the study

The creator of the FSFI is Dr Raymond Rosen, Professor of Psychiatry at Robert Wood Johnson Medical School.

The FSFI questionnaire is based on the study published in the Journal of Sex and Marital Therapy in 2000.

The study involved 131 normal controls and 128 subjects with FSAD already diagnosed.

Each of the six domains presented high test-retest reliability coefficients and the study had a high degree of internal consistency.

Divergent validity with a scale of marital satisfaction has been tested.

There has also been a subsequent validation study which focused on two different groups that included female patients with differing degrees of sexual arousal disorder (FSAD), female orgasmic disorder (FOD) and hypoactive sexual desire disorder (HSDD).

Original source

Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D'Agostino R Jr. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000; 26(2):191-208.

Validation

Meston CM. Validation of the Female Sexual Function Index (FSFI) in Women with Female Orgasmic Disorder and in Women with Hypoactive Sexual Desire Disorder. J Sex Marital Ther. 2003; 29(1): 39–46.