The Female Sexual Function Index (FSFI): A Multidimensional Self-Report Instrument for the Assessment of Female Sexual Function

TLDR

The study develops a concise self‑report instrument to assess female sexual function. The authors refined the questionnaire through expert panel validation and a multicenter study of 259 participants, using principal components analysis to establish a six‑domain structure of desire, arousal, lubrication, orgasm, satisfaction, and pain. The FSFI demonstrated strong reliability (r = 0.79–0.86, α ≥ 0.82) and construct validity, with significant differences between FSAD and control groups (p < 0.001), and divergent validity with marital satisfaction, confirming its psychometric soundness and revealing gender‑specific patterns.

Abstract

Abstract This article presents the development of a brief, self-report measure of female sexual function. Initial face validity testing of questionnaire items, identified by an expert panel, was followed by a study aimed at further refining the questionnaire. It was administered to 131 normal controls and 128 age-matched subjects with female sexual arousal disorder (FSAD) at five research centers. Based on clinical interpretations of a principal components analysis, a 6- domain structure was identified, which included desire, subjective arousal, lubrication, orgasm, satisfaction, and pain. Overall test-retest reliability coefficients were high for each of the individual domains (r=0.79 to 0.86) and a high degree of internal consistency was observed (Cronbach’s alpha values of 0.82 and higher) Good construct validity was demonstrated by highly significant mean difference scores between the FSAD and control groups for each of the domains (p<0.001). Additionally, divergent validity with a scale of marital satisfaction was observed. These results support the reliability and psychometric(as well as clinical) validity of the Female Sexual Function Index (FSFI) in the assessment of key dimensions of female sexual function in clinical and nonclinical samples. Our findings also suggest important gender differences in the patterning of female sexual function in comparison with similar questionnaire studies in males.