Female Sexual Function Index (FSFI)

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INSTRUCTIONS: The questions ask about your sexual feelings and responses DURING THE LAST 4 WEEKS. Please answer as honestly and clearly as possible. Your responses will be kept completely confidential. In answering these questions the following definitions apply: 1) SEXUAL ACTIVITY can include caressing, foreplay, masturbation and vaginal intercourse.

2) SEXUAL INTERCOURSE is defined as penile penetration (entry) of the vagina.

3) SEXUAL STIMULATION includes situations like foreplay with a partner, self-stimulation (masturbation) or sexual fantasy.

4) 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.

5) 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.)

First Name *

Last Name *

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 alwayssor 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

Clear selection

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

Clear selection

9. Over the past 4 weeks, how ofte did you maintain your lubrication (wettness) 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

Clear selection

10. Over the past 4 weeks, how difficuly 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

Clear selection

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

Clear selection

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

Clear selection

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 satisified

4- Moderately satisfied

3- About equally satisfied and dissatisfied

2- Moderately dissatisfied

1- Very dissatisfied

Clear selection

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 satisified

4- Moderately satisfied

3- About equally satisfied and dissatisfied

2- Moderately dissatisfied

1- Very disdatisfied

Clear selection

15. Over the past 4 weeks, how satisfied ave you been with your sexual relationship with your partner?

0- No sexual activity

5- Very satisfied

4- Moderately satisfied

3- About equally satisfied and dissatisfied

2- Moderately dissatisfied

1- Very dissatisfied

Clear selection

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

0- No sexual activity

5- Very satisfied

4- Moderately satisfied

3- About equally satisfied and dissatisfied

2- Moderately dissatisfied

1- Very dissatisfied

Clear selection

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 halt the time)

3- Sometimes (about half the time)

4- A few times ( Less than half the time)

5- Almost never or never

Clear selection

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 halt the time)

3- Sometimes (about half the time)

4- A few times ( Less than half the time)

5- Almost never or never

Clear selection

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 (9-10)

2- High (7-8)

3- Moderate (5-6)

4- Low (2-4)

5- Very low or none at all (0-2)

Clear selection

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