Table of Contents
Abstract
The Female Sexual Function Index (FSFI) is a widely utilized, brief, 19-item self-report questionnaire developed for the rigorous assessment of key dimensions of sexual function in women. As a multidimensional instrument, the FSFI is designed to provide comprehensive, quantitative data across six fundamental domains of sexual health, making it an essential tool for both clinical diagnosis and sexual health research.
Keywords
Female Sexual Function Index, FSFI, Sexual dysfunction, Sexual health, Desire, Arousal, Orgasm, Satisfaction, Pain, Psychometric scale.
Authors
Rosen, C. B., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D., D’Agostino, R.
Purpose
The primary purpose of the FSFI is to provide a standardized, psychometrically sound measure for the assessment of female sexual function. It is specifically used to differentiate between women with normal sexual function and those experiencing symptoms of female sexual dysfunction (FSD).
This instrument is crucial in clinical trials, epidemiological studies, and therapeutic efficacy evaluations, offering a reliable baseline and outcome measure for interventions targeting sexual health and associated disorders.
Construct
The FSFI measures the complex construct of female sexual function by operationalizing it into six distinct, yet interrelated, domains. This multidimensional approach ensures a holistic evaluation of the sexual response cycle, encompassing both subjective psychological states and physiological responses.
The six constructs measured are Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain. These factors align closely with established clinical classifications of sexual difficulties, such as those historically defined by the American Psychiatric Association’s DSM-IV-TR criteria.
Validity
The FSFI demonstrates strong construct validity, having been initially developed and validated on a mixed sample comprising normal control subjects and age-matched women who met diagnostic criteria for sexual dysfunction. Its ability to discriminate effectively between sexually functional women and those with clinical disorders is well-established.
Specific validation studies have confirmed the instrument’s utility across various diagnostic groups, including women diagnosed with Female Sexual Arousal Disorder (FSAD), Female Orgasmic Disorder (FOD), and Hypoactive Sexual Desire Disorder (HSDD), confirming its clinical relevance as a diagnostic screening tool.
Reliability
Psychometric evaluations consistently support the reliability of the FSFI. The scale exhibits excellent internal consistency across its six domains, typically showing high Cronbach’s alpha coefficients, confirming that the items within each domain are measuring the same underlying construct.
Furthermore, test-retest reliability studies have shown that the FSFI produces stable scores over time in populations where sexual function is not expected to change, indicating high stability and dependability of the measure for repeated clinical assessment.
Factor Analysis
Factor analysis of the FSFI confirms its multidimensional structure. The analysis consistently supports a robust six-factor model, corresponding precisely to the six domains of sexual function the scale was designed to measure: Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain.
This clear factor structure reinforces the theoretical foundation of the instrument, validating its use in calculating separate domain scores in addition to a comprehensive total score for overall assessment of female sexual function.
Instrument
Test Type: Self-report questionnaire; Psychological scale.
Format: 19 Likert-style items, typically assessing experiences over the preceding four weeks.
Language Available: English (original); widely translated and validated in numerous languages globally.
Population Group: Adult women.
Age Group: Typically 18 years and older.
Population Details: Used across general population samples, as well as clinical populations diagnosed with various sexual dysfunctions.
Test Methodology: Raw scores are calculated and then weighted and transformed into standardized domain scores. The six transformed domain scores are summed to yield a total score. Higher scores indicate superior sexual functioning (and lower pain levels).
Keywords
FSD, FOD, HSDD, Sexual response cycle, Clinical assessment, Psychometrics, Self-report instrument, Quality of life.
Authors
Author ORCID Identifier: N/A (Information not provided in source)
Affiliation Email addresses: N/A (Information not provided in source)
Correspondence Address: N/A (Information not provided in source)
Permissions & Fee and Test Year
The FSFI was first published in 2000. Permissions for use, scoring algorithms, and associated fees are typically managed by the original authors or associated institutions, and users should consult the primary reference for licensing details.
Reference’s
Rosen, C. B., 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.
Items of the Female Sexual Function Index (FSFI)
Instructions:
Please answer the following questions as honestly and clearly as possible. Your responses will be kept completely confidential. In answering these questions the following definitions apply:
- Sexual activity can include caressing, foreplay, masturbation and vaginal intercourse.
- Sexual intercourse is defined as penile penetration (entry) of the vagina.
- Sexual stimulation includes situations like foreplay with a partner, self-stimulation (masturbation), or sexual fantasy.
| 1 | Over the past 4 weeks, how often did you feel sexual desire or interest? | |
| 5 | Almost always or always | |
| 4 | Most times (more than half the time) | |
| 3 | Sometimes (about half the time) | |
| 2 | A few times (less than half the time) | |
| 1 | Almost never or never | |
| 2 | Over the past 4 weeks, how would you rate your level (degree) of sexual desire or interest? | |
| 5 | Very high | |
| 4 | High | |
| 3 | Moderate | |
| 2 | Low | |
| 1 | Very low or none at all | |
| 3 | Over the past 4 weeks, how often did you feel sexually aroused (“turned on”) during sexual activity or intercourse? | |
| 0 | No sexual activity | |
| 5 | Almost always or always | |
| 4 | Most times (more than half the time) | |
| 3 | Sometimes (about half the time) | |
| 2 | A few times (less than half the time) | |
| 1 | Almost never or never | |
| 4 | Over the past 4 weeks, how would you rate your level of sexual arousal (“turn on”) during sexual activity or intercourse? | |
| 0 | No sexual activity | |
| 5 | Very high | |
| 4 | High | |
| 3 | Moderate | |
| 2 | Low | |
| 1 | Very low or none at all | |
| 5 | Over the past 4 weeks, how confident were you about becoming sexually aroused during sexual activity or intercourse? | |
| 0 | No sexual activity | |
| 5 | Very high confidence | |
| 4 | High confidence | |
| 3 | Moderate confidence | |
| 2 | Low confidence | |
| 1 | Very low or no confidence | |
| 6 | Over the past 4 weeks, how often have you been satisfied with your arousal (excitement) during sexual activity or intercourse? | |
| 0 | No sexual activity | |
| 5 | Almost always or always | |
| 4 | Most times (more than half the time) | |
| 3 | Sometimes (about half the time) | |
| 2 | A few times (less than half the time) | |
| 1 | Almost never or never | |
| 7 | Over the past 4 weeks, how often did you become lubricated (“wet”) during sexual activity or intercourse? | |
| 0 | No sexual activity | |
| 5 | Almost always or always | |
| 4 | Most times (more than half the time) | |
| 3 | Sometimes (about half the time) | |
| 2 | A few times (less than half the time) | |
| 1 | Almost never or never | |
| 8 | Over the past 4 weeks, how difficult was it to become lubricated (“wet”) during sexual activity or intercourse? | |
| 0 | No sexual activity | |
| 1 | Extremely difficult or impossible | |
| 2 | Very difficult | |
| 3 | Difficult | |
| 4 | Slightly difficult | |
| 5 | Not difficult | |
| 9 | Over the past 4 weeks, how often did you maintain your lubrication (“wetness”) until completion of sexual activity or intercourse? | |
| 0 | No sexual activity | |
| 5 | Almost always or always | |
| 4 | Most times (more than half the time) | |
| 3 | Sometimes (about half the time) | |
| 2 | A few times (less than half the time) | |
| 1 | Almost never or never | |
| 10 | Over the past 4 weeks, how difficult was it to maintain your lubrication (“wetness”) until completion of sexual activity or intercourse? | |
| 0 | No sexual activity | |
| 1 | Extremely difficult or impossible | |
| 2 | Very difficult | |
| 3 | Difficult | |
| 4 | Slightly difficult | |
| 5 | Not difficult | |
| 11 | Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you reach orgasm (climax)? | |
| 0 | No sexual activity | |
| 5 | Almost always or always | |
| 4 | Most times (more than half the time) | |
| 3 | Sometimes (about half the time) | |
| 2 | A few times (less than half the time) | |
| 1 | Almost never or never | |
| 12 | Over the past 4 weeks, when you had sexual stimulation or intercourse, how difficult was it for you to reach orgasm (climax)? | |
| 0 | No sexual activity | |
| 1 | Extremely difficult or impossible | |
| 2 | Very difficult | |
| 3 | Difficult | |
| 4 | Slightly difficult | |
| 5 | Not difficult | |
| 13 | Over the past 4 weeks, how satisfied were you with your ability to reach orgasm (climax) during sexual activity or intercourse? | |
| 0 | No sexual activity | |
| 5 | Very satisfied | |
| 4 | Moderately satisfied | |
| 3 | About equally satisfied and dissatisfied | |
| 2 | Moderately dissatisfied | |
| 1 | Very dissatisfied | |
| 14 | Over the past 4 weeks, how satisfied have you been with the amount of emotional closeness during sexual activity between you and your partner? | |
| 0 | No sexual activity | |
| 5 | Very satisfied | |
| 4 | Moderately satisfied | |
| 3 | About equally satisfied and dissatisfied | |
| 2 | Moderately dissatisfied | |
| 1 | Very dissatisfied | |
| 15 | Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner? | |
| 5 | Very satisfied | |
| 4 | Moderately satisfied | |
| 3 | About equally satisfied and dissatisfied | |
| 2 | Moderately dissatisfied | |
| 1 | Very dissatisfied | |
| 16 | Over the past 4 weeks, how satisfied have you been with your overall sexual life? | |
| 5 | Very satisfied | |
| 4 | Moderately satisfied | |
| 3 | About equally satisfied and dissatisfied | |
| 2 | Moderately dissatisfied | |
| 1 | Very dissatisfied | |
| 17 | Over the past 4 weeks, how often did you experience discomfort or pain during vaginal penetration? | |
| 0 | Did not attempt intercourse | |
| 1 | Almost always or always | |
| 2 | Most times (more than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | A few times (less than half the time) | |
| 5 | Almost never or never | |
| 18 | Over the past 4 weeks, how often did you experience discomfort or pain following vaginal penetration? | |
| 0 | Did not attempt intercourse | |
| 1 | Almost always or always | |
| 2 | Most times (more than half the time) | |
| 3 | Sometimes (about half the time) | |
| 4 | A few times (less than half the time) | |
| 5 | Almost never or never | |
| 19 | Over the past 4 weeks, how would you rate your level (degree) of discomfort or pain during or following vaginal penetration? | |
| 0 | Did not attempt intercourse | |
| 1 | Very high | |
| 2 | High | |
| 3 | Moderate | |
| 4 | Low | |
| 5 | Very low or none at all | |
Cite this article
Mohammed looti (2025). Female Sexual Function Index (FSFI). Psychological Scales & Instruments Database. Retrieved from https://db.arabpsychology.com/scales/female-sexual-function-index-fsfi-2/
Mohammed looti. "Female Sexual Function Index (FSFI)." Psychological Scales & Instruments Database, 27 Oct. 2025, https://db.arabpsychology.com/scales/female-sexual-function-index-fsfi-2/.
Mohammed looti. "Female Sexual Function Index (FSFI)." Psychological Scales & Instruments Database, 2025. https://db.arabpsychology.com/scales/female-sexual-function-index-fsfi-2/.
Mohammed looti (2025) 'Female Sexual Function Index (FSFI)', Psychological Scales & Instruments Database. Available at: https://db.arabpsychology.com/scales/female-sexual-function-index-fsfi-2/.
[1] Mohammed looti, "Female Sexual Function Index (FSFI)," Psychological Scales & Instruments Database, vol. X, no. Y, ص Z-Z, October, 2025.
Mohammed looti. Female Sexual Function Index (FSFI). Psychological Scales & Instruments Database. 2025;vol(issue):pages.