Third Annual Female Sexual Function Forum: New Perspectives in the Management of Female Sexual Dysfunction

Lorraine Dennerstein, AO, MBBS, PhD, DPM, FRANZCP

Disclosures

December 05, 2000

In This Article

Measurement of Female Sexual Dysfunction

Most published questionnaires, including those used in the SWAN and Kinsey Institute studies, were developed before the publication of these definitions, so not all of the disorders are addressed by existing questionnaires. Dr. Cindy Meston[13] of the University of Texas at Austin presented an in-depth literature review of instruments designed to assess female sexual function. She cited the FDA guide to industry, which specifies that instruments used in clinical trials of female sexual dysfunction should have demonstrable validity and reliability, should be developed and validated in women with female sexual dysfunction, should be able to measure minimal meaningful differences, and should be able to distinguish patients with and without the disorder of concern. She also highlighted the need for published norms to which researchers and clinicians can relate their findings on a particular woman or group of women.

Her presentation examined the following questionnaires: The Derogatis Interview for Sexual Functioning (DISF),[14] Golombok-Rust Inventory of Sexual Satisfaction (GRISS),[15] Changes in Sexual Functioning Questionnaire (CSFQ 1997),[16] and the newly developed Female Sexual Function Index (FSFI, 2000).[17] All of these were found to have adequate reliability. Some attempt had been made to establish discriminant validity for each scale, and the DISF and GRISS had proven sensitivity to detect score changes with treatment. Published norms were available for all but the GRISS.

Dr. Meston also provided a detailed presentation of the development of the FSFI. This brief self-report instrument focuses on the measurement of female sexual arousal disorder (see "II. Sexual Arousal Disorders," in the Table). The multistage development involved item selection by a panel of experts, pilot testing with 30 subjects at 3 sites in which the FSFI was critiqued individually and in focus groups, and a multicenter study to establish validity and reliability involving 5 sites that provided 259 women, some of whom had female sexual arousal disorder and some of whom were controls. The final version of 19 items has sound psychometric properties and was able to discriminate women with female sexual arousal disorder from controls. For those needing further information on this questionnaire, the Web site address is http://www.FSFIquestionnaire.com.

Most previously published questionnaires have not included the personal distress aspect highlighted in the consensus definitions as critical to female sexual dysfunction. Professor Leonard Derogatis,[18] of the University of Maryland, Baltimore, presented an instrument designed specifically to assess female sexual distress -- the Female Sexual Distress Scale (FSDS). Evaluation of this scale found adequate test-retest reliability, ability to discriminate women with sexual dysfunction from those who do not report dysfunction, and strong correlation with mood measures. Further information can be found at http://www.Derogatis-tests.com.

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