Female Sexual Function Index (FSFI)
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INSTRUCTIONS: 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.
CHECK ONLY ONE BOX PER QUESTION.
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.
Name
*
First
Last
Phone
*
Date / Time
*
Date
Time
Over the past 4 weeks, how often did you feel sexual desire or interest?
*
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
Over the past 4 weeks, how would you rate your level (degree) of sexual desire or interest?
*
Very high
High
Moderate
Low
Very low or none at all
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.
Over the past 4 weeks, how often did you feel sexually aroused ("turned on") during sexual activity or intercourse?
*
No sexual activity
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
Over the past 4 weeks, how would you rate your level of sexual arousal ("turn on") during sexual activity or intercourse?
*
No sexual activity
Very high
High
Moderate
Low
Very low or none at all
Over the past 4 weeks, how confident were you about becoming sexually aroused during sexual activity or intercourse?
*
No sexual activity
Very high confidence
High confidence
Moderate confidence
Low confidence
Very low or no confidence
Over the past 4 weeks, how often have you been satisfied with your arousal (excitement) during sexual activity or intercourse?
*
No sexual activity
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
Over the past 4 weeks, how often did you become lubricated ("wet") during sexual activity or intercourse?
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No sexual activity
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
Over the past 4 weeks, how difficult was it to become lubricated ("wet") during sexual activity or intercourse?
*
No sexual activity
Extremely difficult or impossible
Very difficult
Difficult
Slightly difficult
Not difficult
Over the past 4 weeks, how often did you maintain your lubrication ("wetness") until completion of sexual activity or intercourse?
*
No sexual activity
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
Over the past 4 weeks, how difficult was it to maintain your lubrication ("wetness") until completion of sexual activity or intercourse?
*
No sexual activity
Extremely difficult or impossible
Very difficult
Difficult
Slightly difficult
Not difficult
Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you reach orgasm (climax)?
*
No sexual activity
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
Over the past 4 weeks, when you had sexual stimulation or intercourse, how difficult was it for you to reach orgasm (climax)?
*
No sexual activity
Extremely difficult or impossible
Very difficult
Difficult
Slightly difficult
Not difficult
Over the past 4 weeks, how satisfied were you with your ability to reach orgasm (climax) during sexual activity or intercourse?
*
No sexual activity
Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied
Over the past 4 weeks, how satisfied have you been with the amount of emotional closeness during sexual activity between you and your partner?
*
No sexual activity
Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied
Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner?
*
Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied
Over the past 4 weeks, how satisfied have you been with your overall sexual life?
*
Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied
Over the past 4 weeks, how often did you experience discomfort or pain during vaginal penetration?
*
Did not attempt intercourse
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
Over the past 4 weeks, how often did you experience discomfort or pain following vaginal penetration?
*
Did not attempt intercourse
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
Over the past 4 weeks, how would you rate your level (degree) of discomfort or pain during or following vaginal penetration?
*
Did not attempt intercourse
Very high
high
Moderate
Low
Very low or none at all
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