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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:

Domain	Questions	Item Score Range	Factor	Minimum Score	Maximum Score
Desire	1, 2	1-5	0.6	1.2	6.0
Arousal	3, 4, 5, 6	0-5	0.3	1.2	6.0
Lubrication	7, 8, 9, 10	0-5	0.3	1.2	6.0
Orgasm	11, 12, 13	0-5	0.4	1.2	6.0
Satisfaction	14, 15, 16	0 (or 1)-5	0.4	1.2	6.0
Pain	17, 18, 19	0-5	0.4	1.2	6.0

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.

All questions & possible results

Desire

Q1: Over the past 4 weeks, how often did you feel sexual desire or interest?

Select one option:

Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

Q2: Over the past 4 weeks, how would you rate your level (degree) of sexual desire or interest?

Select one option:

Very high
High
Moderate
Low
Very low or none at all

In the past 4 weeks, have you had sexual activity or intercourse?

Select one option:

Arousal

Q3: Over the past 4 weeks, how often did you feel sexually aroused (“turned on”) during sexual activity or intercourse?

Select one option:

Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

Q4: Over the past 4 weeks, how would you rate your level of sexual arousal ("turn on") during sexual activity or intercourse?

Select one option:

Very high
High
Moderate
Low
Very low or none at all

Q5: Over the past 4 weeks, how confident were you about becoming sexually aroused during sexual activity or intercourse?

Select one option:

Very high confidence
High confidence
Moderate confidence
Low confidence
Very low or no confidence

Q6: Over the past 4 weeks, how often have you been satisfied with your arousal (excitement) during sexual activity or intercourse?

Select one option:

Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

Lubrication

Q7: Over the past 4 weeks, how often did you become lubricated (“wet”) during sexual activity or intercourse?

Select one option:

Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

Q8: Over the past 4 weeks, how difficult was it to become lubricated ("wet") during sexual activity or intercourse?

Select one option:

Extremely difficult or impossible
Very difficult
Difficult
Slightly difficult
Not difficult

Q9: Over the past 4 weeks, how often did you maintain your lubrication (“wetness”) until completion of sexual activity or intercourse?

Select one option:

Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

Q10: Over the past 4 weeks, how difficult was it to maintain your lubrication (“wetness”) until completion of sexual activity or intercourse?

Select one option:

Extremely difficult or impossible
Very difficult
Difficult
Slightly difficult
Not difficult

Orgasm

Q11: Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you reach orgasm (climax)?

Select one option:

Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

Q12: Over the past 4 weeks, when you had sexual stimulation or intercourse, how difficult was it for you to reach orgasm (climax)?

Select one option:

Extremely difficult or impossible
Very difficult
Difficult
Slightly difficult
Not difficult

Q13: Over the past 4 weeks, how satisfied were you with your ability to reach orgasm (climax) during sexual activity or intercourse?

Select one option:

Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied

Satisfaction

Q14: Over the past 4 weeks, how satisfied have you been with the amount of emotional closeness during sexual activity between you and your partner?

Select one option:

Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied

Q15: Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner?

Select one option:

Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied

Q16: Over the past 4 weeks, how satisfied have you been with your overall sexual life?

Select one option:

Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied

Pain

Q17: Over the past 4 weeks, how often did you experience discomfort or pain during vaginal penetration?

Select one option:

Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

Q18: Over the past 4 weeks, how often did you experience discomfort or pain following vaginal penetration?

Select one option:

Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

Q19: Over the past 4 weeks, how would you rate your level (degree) of discomfort or pain during or following vaginal penetration?

Select one option:

Very high
High
Moderate
Low
Very low or none at all

Possible results

Pain Domain Score

A low score suggests female dysfunction in this domain (Minimum score is 1.2). A high score represents minimal to no pain or discomfort.

Q17: How often did you experience discomfort or pain during vaginal penetration?
Q18: How often did you experience discomfort or pain following vaginal penetration?
Q19: How would you rate your level (degree) of discomfort or pain during or following vaginal penetration?

FSFI Full Scale Score

A low score (≤ 26.55) suggests female sexual dysfunction.

Desire Domain Score