Summary

What it measures:

This patient-reported outcome measure rates 6 dimensions of sexual functioning in women: desire, arousal, lubrication, orgasm, satisfaction, and pain.

Information in this summary pertains to the original tool, FSFI-19; a shortened version of the survey, FSFI-6, became available in 2010 and may have value as a screening tool.

Target Population:

• Validated for sexually active, heterosexual women.¹
• One study supports the use of FSFI with lesbian women.²
• This tool has been translated and culturally validated in many different languages.³ Existing translations can be obtained from Mapi Research Trust.
• Adaptations of this tool have been developed for use with the following populations:
  • Breast cancer survivors. The FSFI-BC measures distress and changes after cancer in both sexually active and non-sexually active women.⁴
  • Sexual and gender minority individuals.⁵ One example is the Transmasculine Sexual Function Index (TM-SFI), for sexually active transmasculine individuals with cervixes.⁶

Clinical insights: FSFI is the most widely used self-report measure for assessing sexual function in women.² The main weaknesses of the tool include that it does not measure sexual distress; it has not been validated beyond heterosexual populations⁷; and the coding is inadequate for sexually inactive people.³ To provide further insight and corroborate an FSFI score that suggests sexual dysfunction in women, clinicians can choose to administer question No. 13 from the Female Sexual Distress Scale-Revised (FSDS-R). The U.S. Department of Health and Human Services Food and Drug Administration considers this item "acceptable for measuring bother (a component of distress) related to decreased sexual desire."⁸

The DSM-V updates in 2013, merged the issues of desire and arousal into a single disorder.⁹ This model suggests that desire and arousal may not be separate constructs in the context of sexual dysfunction in women. New literature suggests grouping the FSFI dimensions of desire and arousal; however, this has yet to be evaluated.³ Therefore, a clinician cannot specify the type of dysfunction a patient may be experiencing but simply conclude that sexual dysfunction is present when patients score below the cut-off score.

In addition, noted associations between sexual function and other variables, such as psychological distress, alcohol use, and trauma¹⁰ may warrant additional screening and referral to an appropriate health care provider when indicated.