Content validity of the female sexual function index (FSFI) in pre- and postmenopausal women with hypoactive sexual desire disorder

Dennis A. Revicki, Mary K. Margolis, Elizabeth N. Bush, Leonard R. Derogatis, Vladimir Hanes

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Introduction. The Female Sexual Function Index (FSFI) has consistently been shown to have discriminant validity, test-retest reliability, and internal consistency as a measure of female sexual function. However, the content validity (relevance, clarity, comprehensiveness) of the instrument in women with hypoactive sexual desire disorder (HSDD) must also be established. Aim. The aim of this study were to assess the content validity of the FSFI, specifically the FSFI desire domain, in pre- and postmenopausal women with HSDD. Methods. Two single-visit content validation studies were conducted in the United States. Eligible premenopausal (both studies) and postmenopausal (second study only) women with HSDD completed the FSFI followed by one-on-one, face-to-face cognitive debriefing interviews including open-ended questions to capture information on their perceptions of the instrument. Information on women's experiences of decreased sexual desire was also captured. Main Outcome Measures. The main outcome measures of this study were the women's ratings of the clarity, ease of understanding, comprehensiveness, and relevance of the 19 items of the FSFI. Results. Interviews with 15 premenopausal women (first study), and 30 pre- and 31 postmenopausal women (second study), were analyzed. Across the whole sample, most women (80-100%) found every item of the FSFI clear and easy to understand. The majority (53-70%) felt that the FSFI captured all their feelings about decreased sexual desire and other sexual problems, and most (84-90%) indicated that additional questions were unnecessary. Most women in both studies (93-100%) reported that the two items comprising the FSFI desire domain were clear, easy to understand, and were relevant to them. The majority of women thought that a recall period of ≥7 days is most relevant for recall of their sexual desire. Conclusions. These studies establish the content validity of the FSFI in pre- and postmenopausal women with HSDD, supporting the use of this instrument as a measure of sexual function in women with this condition.

Original languageEnglish (US)
Pages (from-to)2237-2245
Number of pages9
JournalJournal of Sexual Medicine
Issue number8
StatePublished - Aug 2011


  • FSFI
  • Female Sexual Function Index
  • HSDD
  • Hypoactive Sexual Desire Disorder
  • PRO
  • Patient-Reported Outcome
  • Validation

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Urology


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