Female Sexual Function Index (FSFI)

Purpose

The Female Sexual Function Index (FSFI) is a widely used, brief, multidimensional self-report instrument for assessing key dimensions of sexual function in women over the past 4 weeks. It consists of 19 items.

Scoring System

The FSFI assesses six domains:

• Desire (Items 1, 2)
• Arousal (Items 3, 4, 5, 6)
• Lubrication (Items 7, 8, 9, 10)
• Orgasm (Items 11, 12, 13)
• Satisfaction (Items 14, 15, 16)
• Pain (Items 17, 18, 19)

Individual domain scores are calculated by summing the scores of the items within that domain and multiplying the sum by the domain factor. The full scale score is obtained by adding the six domain scores. A domain score of zero indicates that no sexual activity was reported during the past month for the items comprising that domain.

The scoring details are as follows:

Full Scale Score Range: 7.2 - 36.0

💡 Key Points from the FSFI Guidelines:

• "No sexual activity" (zero score) is not a measure of dysfunction — it simply means that the activity didn’t occur. It is conceptually distinct from responses on sexual function.
• If a participant answers "No sexual activity" for one FSFI question then the domain is scored as "0" according to the paper version of the FSFI.
• For domains other than Desire, if any question within that domain is marked "No sexual activity", you should not score the domain at all for that participant. Including the other (numeric) answers would bias the score downward and create invalid data.
• Desire domain is the only one that can be scored regardless of activity, since it does not require sexual behavior—only interest.
• For these reasons, this app asks a triage question (Have you had sexual activity or intercourse in the past 4 weeks?) prior to the arousal domain. If the answer is no, the remaining domain questions are not presented and the following result will appear:
  • No sexual activity or intercourse reported in the past 4 weeks. Unable to assess the following domains:
    • Arousal
    • Lubrication
    • Orgasm
    • Satisfaction
    • Pain
  • Consider modified version of FSFI (e.g., lifelong version) if assessing long-term or broader patterns.

Limitations

The FSFI relies on subjective patient recall over the previous 4 weeks. Scores can be influenced by various factors including relationship status, emotional well-being, and cultural background. It assesses the presence and severity of sexual difficulties but does not diagnose specific underlying causes.