Description

The Female Sexual Distress Scale – Revised (FSDS-R) is an internationally recognized psychometric instrument developed to assess the subjective psychological distress associated with female sexual functioning. Unlike instruments that exclusively measure sexual response or the frequency of sexual behaviors, the FSDS-R specifically evaluates the emotional burden that sexual difficulties impose on a woman’s daily life.

The scale is the revised version of the original Female Sexual Distress Scale (FSDS) and consists of 13 items assessing the frequency with which respondents experience emotions such as frustration, anxiety, worry, embarrassment, discouragement, and psychological distress related to their sexual life during the previous four weeks.

The FSDS-R is widely used in gynecology, sexual medicine, psychiatry, psychology, reproductive medicine, and psychotherapy. It is considered a key instrument for the assessment of Female Sexual Interest/Arousal Disorder (FSIAD) and other forms of female sexual dysfunction according to contemporary diagnostic criteria.

Analysis

The Female Sexual Distress Scale – Revised (FSDS-R) enables the objective assessment of the psychological distress associated with sexual difficulties and facilitates the distinction between the mere presence of sexual dysfunction and the clinically significant distress resulting from it.

FSDS-R scores can be used to:

  • identify clinically significant sexual distress;
  • evaluate the severity of negative emotions associated with sexual functioning;
  • investigate the relationship between sexual distress and depression, anxiety, self-esteem, and quality of life;
  • evaluate the effectiveness of pharmacological, psychotherapeutic, and counseling interventions;
  • examine the impact of chronic diseases, hormonal changes, gynecological conditions, and medical treatments on sexual well-being.

From a research perspective, FSDS-R 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), linear and logistic regression analyses, and Structural Equation Modeling (SEM), depending on the objectives and design of the study.

Objective

The primary objective of the Female Sexual Distress Scale – Revised (FSDS-R) is to provide a reliable and valid assessment of the psychological distress associated with female sexual functioning, thereby contributing to a comprehensive understanding of women’s sexual health.

More specifically, the instrument aims to:

  • identify women experiencing clinically significant sexual distress;
  • distinguish between reduced sexual functioning and the actual psychological burden caused by sexual difficulties;
  • support the diagnosis of female sexual dysfunctions according to internationally accepted diagnostic criteria;
  • monitor patients’ progress following therapeutic or psychosocial interventions;
  • investigate the biological, psychological, and social factors influencing sexual well-being and quality of life.

The FSDS-R is frequently administered alongside the Female Sexual Function Index (FSFI), as the two instruments provide complementary information regarding sexual functioning and the emotional consequences of sexual difficulties.

Scoring

The Female Sexual Distress Scale – Revised (FSDS-R) consists of 13 statements that assess the frequency of emotions associated with sexual distress experienced during the previous four weeks.

Responses are recorded using a 5-point Likert scale:

0 = Never

1 = Rarely

2 = Occasionally

3 = Frequently

4 = Always

The total score is calculated by summing the responses to all items, yielding a possible score ranging from 0 to 52.

  • Higher scores indicate greater levels of sexual distress and more severe psychological burden.
  • Lower scores reflect minimal or no emotional distress associated with sexual functioning.

The international literature has proposed a cutoff score of ≥11 as an indicator of clinically significant sexual distress. However, interpretation of FSDS-R scores should always be made in conjunction with a comprehensive clinical evaluation, medical history, and other specialized measures of sexual functioning.

The FSDS-R demonstrates excellent psychometric properties, including high internal consistency (Cronbach’s α), strong test–retest reliability, and well-established convergent and discriminant validity across numerous international validation studies.

References

Derogatis, L. R., Clayton, A. H., Lewis-D’Agostino, D. J., Wunderlich, G., & Fu, Y. (2008). Validation of the Female Sexual Distress Scale–Revised for assessing distress in women with hypoactive sexual desire disorder. The Journal of Sexual Medicine, 5(2), 357–364. https://doi.org/10.1111/j.1743-6109.2007.00672.x.

Derogatis, L. R., Rosen, R., Leiblum, S., Burnett, A., & Heiman, J. (2002). The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexually related personal distress in women. Journal of Sex & Marital Therapy, 28(4), 317–330.

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.

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

Clayton, A. H., Goldfischer, E. R., Goldstein, I., DeRogatis, L. R., Lewis-D’Agostino, D. J., & Pyke, R. (2016). Validation of the Female Sexual Distress Scale–Revised in women with decreased sexual desire. Journal of Sexual Medicine, 13(7), 1058–1065.

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Publishing.