Female Sexual Function Index (FSFI)
Measures six domains of female sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain.
Provided by
ISSWSHDesire
These questions ask about your sexual feelings and responses during the past 4 weeks.
- 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.
- Sexual desire or interest is a feeling that includes wanting to have a sexual experience, feeling receptive to a partner's sexual initiation, and thinking or fantasizing about having sex.
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.
- No sexual activity or intercourse reported in the past 4 weeks. Unable to assess the following domains:
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
These questions ask about your sexual feelings and responses during the past 4 weeks.
- 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.
- Sexual desire or interest is a feeling that includes wanting to have a sexual experience, feeling receptive to a partner's sexual initiation, and thinking or fantasizing about having sex.
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:
- Yes
- No
Arousal
These questions ask about your sexual feelings and responses during the past 4 weeks.
- 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.
- Sexual arousal is a feeling that includes both physical and mental aspects of sexual excitement. It may include feelings of warmth or tingling in the genitals, lubrication (wetness), or muscle contractions.
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
These questions ask about your sexual feelings and responses during the past 4 weeks.
- 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.
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
These questions ask about your sexual feelings and responses during the past 4 weeks.
- 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.
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
These questions ask about your sexual feelings and responses during the past 4 weeks.
- 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.
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
These questions ask about your sexual feelings and responses during the past 4 weeks.
- 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.
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
Orgasm Domain Score
A low score suggests female dysfunction in this domain (Minimum score is 1.2).
- Q11: When you had sexual stimulation or intercourse, how often did you reach orgasm (climax)?
- Q12: When you had sexual stimulation or intercourse, how difficult was it for you to reach orgasm (climax)?
- Q13: How satisfied were you with your ability to reach orgasm (climax) during sexual activity or intercourse?
Arousal Domain Score
A low score suggests female dysfunction in this domain (Minimum score is 1.2).
- Q3: How often did you feel sexually aroused ("turned on") during sexual activity or intercourse?
- Q4: How would you rate your level of sexual arousal ("turn on") during sexual activity or intercourse?
- Q5: How confident were you about becoming sexually aroused during sexual activity or intercourse?
- Q6: How often have you been satisfied with your arousal (excitement) during sexual activity or intercourse?
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?
Lubrication Domain Score
A low score suggests female dysfunction in this domain (Minimum score is 1.2).
- Q7: How often did you become lubricated ("wet") during sexual activity or intercourse?
- Q8: How difficult was it to become lubricated ("wet") during sexual activity or intercourse?
- Q9: How often did you maintain your lubrication ("wetness") until completion of sexual activity or intercourse?
- Q10: How difficult was it to maintain your lubrication ("wetness") until completion of sexual activity or intercourse?
Satisfaction Domain Score
A low score suggests female dysfunction in this domain (Minimum score is 1.2).
- Q14: How satisfied have you been with the amount of emotional closeness during sexual activity between you and your partner?
- Q15: How satisfied have you been with your sexual relationship with your partner?
- Q16: How satisfied have you been with your overall sexual life?
FSFI Full Scale Score
Please discuss with your health care provider. Further assessment may still be needed depending on clinical presentation.
- A low score (≤ 26.55) suggests female sexual dysfunction.
Medical Disclaimer & Terms of Use
- This assessment is for educational and informational purposes only. It is not a diagnostic tool and does not constitute medical advice, a professional diagnosis, an opinion, or a plan of treatment.
- Consult Your Doctor: The results of this electronic assessment are intended to be a starting point for a conversation with a qualified healthcare professional. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
- No Doctor-Patient Relationship: Use of this electronic tool does not create a doctor-patient relationship between you and the developers of this assessment. If you are experiencing a medical emergency, please stop and call your local emergency services or go to the nearest emergency room immediately.
- Accuracy of Data: By using this tool, you acknowledge that self-reported data is subjective. While this assessment utilizes validated scoring logic (such as the FSFI or DSDS), the interpretation of these scores requires clinical context that can only be provided by a licensed medical provider.
Desire Domain Score
A low score suggests female dysfunction in this domain (Minimum score is 1.2).
- Q1: How often did you feel sexual desire or interest?
- Q2: How would you rate your level (degree) of sexual desire or interest?
No sexual activity or intercourse reported in the past 4 weeks.
Unable to assess the following domains:
- Arousal
- Lubrication
- Orgasm
- Satisfaction
- Pain
Citation
Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D., & D’Agostino, R., Jr. (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.
©2000 Raymond Rosen
Literature
- The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26:191-208. — Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D'Agostino R Jr.
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