Description

The Female Sexual Function Index (FSFI) is one of the most widely used and scientifically validated psychometric instruments for assessing female sexual function. Developed by Rosen and colleagues, the FSFI provides a comprehensive evaluation of the principal dimensions of female sexual health and is extensively utilized in both clinical practice and scientific research.

The questionnaire consists of 19 items that assess female sexual functioning over the previous four weeks across six core domains:

  • Sexual Desire
  • Sexual Arousal
  • Lubrication
  • Orgasm
  • Satisfaction
  • Pain

This multidimensional approach enables a comprehensive assessment of female sexual functioning, facilitating the early identification of sexual dysfunctions and the evaluation of therapeutic or psychosocial interventions.

The FSFI is widely applied in gynecology, urogynecology, psychiatry, psychology, sexual medicine, reproductive medicine, and quality-of-life research involving women.

Analysis

The Female Sexual Function Index (FSFI) enables the quantitative assessment of overall female sexual functioning as well as each of its individual domains.

FSFI scores can be used to:

  • screen for female sexual dysfunction;
  • assess the severity of impairments across different domains of sexual function;
  • investigate the relationship between sexual function and physical as well as mental health;
  • examine the effects of hormonal, gynecological, or chronic medical conditions on sexual functioning;
  • evaluate the effectiveness of pharmacological, surgical, psychotherapeutic, or counseling interventions;
  • explore associations between sexual function, quality of life, self-esteem, relationship quality, and overall well-being.

From a research perspective, FSFI data can be analyzed using descriptive statistics, reliability analyses (Cronbach’s α), Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), correlation analyses, group comparisons (independent-samples t-tests, ANOVA, and MANOVA), as well as regression models and Structural Equation Modeling (SEM), depending on the objectives of the study.

Objective

The primary objective of the Female Sexual Function Index (FSFI) is to provide a reliable and valid assessment of female sexual functioning by offering a comprehensive evaluation of the various dimensions that influence women’s sexual health.

More specifically, the instrument aims to:

  • facilitate the early identification of female sexual dysfunction;
  • evaluate the severity and nature of impairments across each domain of sexual functioning;
  • support clinical diagnosis and individualized treatment planning;
  • monitor patients’ progress following therapeutic or psychoeducational interventions;
  • investigate the relationships between sexual functioning and biological, psychological, and social factors.

The FSFI is currently regarded as the gold standard among self-report instruments for assessing female sexual function and has been employed in a large number of international clinical studies.

Scoring

The Female Sexual Function Index (FSFI) consists of 19 items distributed across six subscales representing the major domains of female sexual functioning. Participants evaluate their sexual experiences during the previous four weeks using Likert-type response scales, typically ranging from 0 or 1 to 5, depending on the content of each item.

Each domain score is calculated by summing the corresponding item responses and multiplying the result by a predetermined weighting factor. The weighted domain scores are subsequently summed to produce the overall FSFI score.

The total FSFI score ranges from 2 to 36, where:

  • Higher scores indicate better sexual functioning.
  • Lower scores indicate a greater likelihood of female sexual dysfunction.

According to the international literature, a total FSFI score of 26.55 or below has been proposed as the clinical cutoff for identifying women at risk of sexual dysfunction. Nevertheless, interpretation of the results should always be performed in conjunction with the individual’s medical history, clinical evaluation, and other specialized diagnostic procedures.

References

Rosen, R. C., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D., & D’Agostino, R. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex & Marital Therapy, 26(2), 191–208. https://doi.org/10.1080/009262300278597.

Wiegel, M., Meston, C., & Rosen, R. (2005). The Female Sexual Function Index (FSFI): Cross-validation and development of clinical cutoff scores. Journal of Sex & Marital Therapy, 31(1), 1–20. https://doi.org/10.1080/00926230590475206.

Meston, C. M. (2003). Validation of the Female Sexual Function Index (FSFI) in women with female orgasmic disorder and in women with hypoactive sexual desire disorder. Journal of Sex & Marital Therapy, 29(1), 39–46.

Isidori, A. M., Pozza, C., Esposito, K., et al. (2010). Development and validation of a 6-item version of the Female Sexual Function Index (FSFI-6). Journal of Sexual Medicine, 7(3), 1139–1146.

Meston, C. M., & Buss, D. M. (2007). Why humans have sex. Archives of Sexual Behavior, 36(4), 477–507.

Clayton, A. H., & Valladares Juárez, E. M. (2017). Female sexual dysfunction. Medical Clinics of North America, 103(4), 681–698.