Sexual Desire and the Female Sexual Function Index (FSFI): A Sexual Desire Cutpoint for Clinical Interpretation of the FSFI in Women with and without Hypoactive Sexual Desire Disorder

Abstract

Introduction A validated cutpoint for the total Female Sexual Function Index scale score exists to classify women with and without sexual dysfunction. However, there is no sexual desire (SD) domain-specific cutpoint for assessing the presence of diminished desire in women with or without a sexual desire problem. Aims This article defines and validates a specific cutpoint on the SD domain for differentiating women with and without hypoactive sexual desire disorder (HSDD). Methods Eight datasets (618 women) were included in the development dataset. Four independent datasets (892 women) were used in the validation portion of the study. Main Outcome Measures Diagnosis of HSDD was clinician-derived. Receiver-operator characteristic (ROC) curves were used to develop the cutpoint, which was confirmed in the validation dataset. Results The use of a diagnostic cutpoint for classifying women with SD scores of 5 or less on the SD domain as having HSDD and those with SD scores of 6 or more as not having HSDD maximized diagnostic sensitivity and specificity. In the development sample, the sensitivity and specificity for predicting HSDD (with or without other conditions) were 75% and 84%, respectively, and the corresponding sensitivity and specificity in the validation sample were 92% and 89%, respectively. Conclusions These analyses support the diagnostic accuracy of the SD domain for use in future observational studies and clinical trials of HSDD.

Sexual Desire Problems in Women Seeking Healthcare: A Novel Study Design for Ascertaining Prevalence of Hypoactive Sexual Desire Disorder in Clinic-Based Samples of U.S. Women

“…15,16 Finally, the desire score for HSDD cases in the present study (3.0 -1.3) was well below the recently established FSFI sexual desire clinical cutoff point of 5.0. 27 …”

Characteristics of premenopausal and postmenopausal women with acquired, generalized hypoactive sexual desire disorder

“…26,27 In addition, we have recently shown that a cut point of 5 or less on the sexual desire domain can be used to differentiate women with and without symptoms of HSDD. 24 …”

“…25 The FSFI desire domain score was similarly well below the recently validated cut point of 5.0, again indicating diminished sexual functioning. 24 Current diagnosis of the medical condition as assessed by clinician medical history review. Only conditions that are reported for 5% or more of participants are itemized; others are also included in the total when categorizing women with four or more current medical conditions.…”

A Longitudinal Study of Problems in Sexual Functioning and Related Sexual Distress Among Middle to Late Adolescents

“…Scores were derived for adolescents who reported partnered sexual activity within the prior 4-week period and at least one past occasion of oral, vaginal, or anal sex. For the predictive analyses, female respondents were classified as having had a persistent sexual problem at any given assessment if they reported: a score of 5 on the desire domain or a total FSFI score of 26.55 as these are the only domains with validated cutoff scores [27,28]. For descriptive purposes, scores below the midpoint on the remaining domains indicate low sexual functioning (i.e., at least half the time, no/low desire or arousal, difficulty to extreme difficulty, moderate to high dissatisfaction, high to very high pain, or no/low confidence in functioning).…”