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


Raymond C. Rosen, PhD, New England Research Institutes, Inc., 9 Galen St, Watertown, MA 02472. Tel: 617-923-7747; Fax: 617-926-0144; E-mail:


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. Gerstenberger EP, Rosen RC, Brewer JV, Meston CM, Brotto LA, Wiegel M, and Sand M. 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. J Sex Med 2010;7:3096–3103.