Female Sexual Function Index (FSFI)

1 Page 1 (of 5) Female Sexual Function Index ( fsfi ) Subject Identifier _____ Date _____INSTRUCTIONS: These questions ask about your Sexual feelings and responsesduring the past 4 weeks. Please answer the following questions as honestly andclearly as possible. Your responses will be kept completely confidential. Inanswering these questions the following definitions apply: Sexual activity can include caressing, foreplay, masturbation and vaginal intercourse is defined as penile penetration (entry) of the stimulation includes situations like foreplay with a partner, self-stimulation(masturbation), or Sexual ONLY ONE BOX PER desire or interest is a feeling that includes wanting to have a sexualexperience, feeling receptive to a partner's Sexual initiation, and thinking orfantasizing about having Over the past 4 weeks, how often did you feel Sexual desire or interest?

2 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 never2. Over the past 4 weeks, how would you rate your level (degree) of Sexual desireor interest?Very highHighModerateLowVery low or none at all Page 2 (of 5) Sexual arousal is a feeling that includes both physical and mental aspects of sexualexcitement. It may include feelings of warmth or tingling in the genitals, lubrication(wetness), or muscle Over the past 4 weeks, how often did you feel sexually aroused ("turned on")during Sexual activity or intercourse?

3 No Sexual activityAlmost always or alwaysMost times (more than half the time)Sometimes (about half the time)A few times (less than half the time)Almost never or never4. Over the past 4 weeks, how would you rate your level of Sexual arousal ("turnon") during Sexual activity or intercourse?No Sexual activityVery highHighModerateLowVery low or none at all5. Over the past 4 weeks, how confident were you about becoming sexuallyaroused during Sexual activity or intercourse?No Sexual activityVery high confidenceHigh confidenceModerate confidenceLow confidenceVery low or no confidence6.

4 Over the past 4 weeks, how often have you been satisfied with your arousal(excitement) during Sexual activity or intercourse?No Sexual activityAlmost always or alwaysMost times (more than half the time)Sometimes (about half the time)A few times (less than half the time)Almost never or never Page 3 (of 5)7. Over the past 4 weeks, how often did you become lubricated ("wet") duringsexual activity or intercourse?No Sexual activityAlmost always or alwaysMost times (more than half the time)Sometimes (about half the time)A few times (less than half the time)Almost never or never8.

5 Over the past 4 weeks, how difficult was it to become lubricated ("wet") duringsexual activity or intercourse?No Sexual activityExtremely difficult or impossibleVery difficultDifficultSlightly difficultNot difficult9. Over the past 4 weeks, how often did you maintain your lubrication ("wetness")until completion of Sexual activity or intercourse?No Sexual activityAlmost always or alwaysMost times (more than half the time)Sometimes (about half the time)A few times (less than half the time)Almost never or never10. Over the past 4 weeks, how difficult was it to maintain your lubrication("wetness") until completion of Sexual activity or intercourse?

6 No Sexual activityExtremely difficult or impossibleVery difficultDifficultSlightly difficultNot difficult Page 4 (of 5)11. Over the past 4 weeks, when you had Sexual stimulation or intercourse, howoften did you reach orgasm (climax)?No Sexual activityAlmost always or alwaysMost times (more than half the time)Sometimes (about half the time)A few times (less than half the time)Almost never or never12. Over the past 4 weeks, when you had Sexual stimulation or intercourse, howdifficult was it for you to reach orgasm (climax)?No Sexual activityExtremely difficult or impossibleVery difficultDifficultSlightly difficultNot difficult13.

7 Over the past 4 weeks, how satisfied were you with your ability to reach orgasm(climax) during Sexual activity or intercourse?No Sexual activityVery satisfiedModerately satisfiedAbout equally satisfied and dissatisfiedModerately dissatisfiedVery dissatisfied14. Over the past 4 weeks, how satisfied have you been with the amount ofemotional closeness during Sexual activity between you and your partner?No Sexual activityVery satisfiedModerately satisfiedAbout equally satisfied and dissatisfiedModerately dissatisfiedVery dissatisfiedCopyright 2000 All Rights Reserved Page 5 (of 5)15.

8 Over the past 4 weeks, how satisfied have you been with your sexualrelationship with your partner?Very satisfiedModerately satisfiedAbout equally satisfied and dissatisfiedModerately dissatisfiedVery dissatisfied16. Over the past 4 weeks, how satisfied have you been with your overall Sexual life?Very satisfiedModerately satisfiedAbout equally satisfied and dissatisfiedModerately dissatisfiedVery dissatisfied17. Over the past 4 weeks, how often did you experience discomfort or pain duringvaginal penetration?Did not attempt intercourseAlmost always or alwaysMost times (more than half the time)Sometimes (about half the time)A few times (less than half the time)Almost never or never18.

9 Over the past 4 weeks, how often did you experience discomfort or pain followingvaginal penetration?Did not attempt intercourseAlmost always or alwaysMost times (more than half the time)Sometimes (about half the time)A few times (less than half the time)Almost never or the past 4 weeks, how would you rate your level (degree) of discomfort orpain during or following vaginal penetration?Did not attempt intercourseVery highHighModerateLowVery low or none at allThank you for completing this questionnair