Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of the Female Sexual Function Index in a Population Based Sample from Finland

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

The factor structure and reliability of the Female Sexual Function Index (FSFI) was evaluated in a Finnish population based sample of 2,081 women, age 33–43 years. In addition, associations between female sexual function and age, psychological distress, alcohol use, hormone based contraceptives, child sexual abuse (CSA), and adult sexual abuse were examined. The results supported a six factor solution for the FSFI with high internal consistencies, in line with earlier research in clinical populations. Psychological distress was positively associated with every dimension of the FSFI except desire problems. Age was associated with fewer pain problems. Alcohol use was associated with every dimension of the FSFI, but the direction of the association depended on if it was drinking in general or in connection to intercourse. More drinking in general was related to fewer sexual function problems while drinking in connection to intercourse was related to more sexual function problems. No significant correlation was found between adult sexual abuse and sexual function but between CSA and lubrication, satisfaction, and pain problems. Usage of oral contraceptive pill was not significantly associated with sexual function. The use of hormone based intrauterine systems was significantly associated with less pain and more desire, arousal, and satisfaction. In conclusion, the study supports use of the FSFI for assessing sexual function not only in clinical samples but also in population based samples. The associations found between sexual function and other important variables showed the complexity of sexual function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Abbey, A., Zawacki, T., & McAuslan, P. (2000). Alcohol’s effects on sexual perception. Journal of Studies of Alcohol, 61, 688–697.

    CAS  Google Scholar 

  • Abdo, C. H. N., Oliviera, W. M., Moreira, E. D., & Fittipaldi, J. A. S. (2004). Prevalence of sexual dysfunctions and correlated conditions in a sample of Brazilian women: Results of the Brazilian study on sexual behavior (BSSB). International Journal of Impotence Research, 16, 160–166.

    Article  PubMed  CAS  Google Scholar 

  • Andrew, T., Hart, D. J., Snieder, H., de Lange M., Spector, T. D., & MacGregor, A. J. (2001). Are twins and singletons comparable? A study of disease-related and lifestyle characteristics in adult women. Twin Research, 4, 464–477.

    Article  PubMed  CAS  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.

    Google Scholar 

  • Arbuckle, J. L., & Wothke, W. (1995–1999). Amos 4.0 user’s guide. Chicago: SmallWaters Corporation.

  • Aydin, G., Başar, M. M., Keleş, I., Ergün, G., Orkun, S., & Batişlam, E. (2006). Relationship between sexual dysfunction and psychiatric status in premenopausal women with fibromyalgia. Urology, 67, 156–161.

    Article  PubMed  Google Scholar 

  • Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). The alcohol use disorders identification test: Guidelines for use in primary care (WHO document WHO/MSD/MSB/01.6a). Geneva: WHO.

    Google Scholar 

  • Bailey, J. M., Dunne, M. P., & Martin, N. G. (2000). Genetic and environmental influences on sexual orientation and its correlates in an Australian twin sample. Journal of Personality and Social Psychology, 78, 524–536.

    Article  PubMed  CAS  Google Scholar 

  • Bancroft, J., Loftus, J., & Long, J. S. (2003). Distress about sex: A national survey of women in heterosexual relationships. Archives of Sexual Behavior, 32, 193–208.

    Article  PubMed  Google Scholar 

  • Basson, R. (2005). Women’s sexual dysfunction: Revised and expanded definitions. Canadian Medical Association Journal, 172, 1327–1333.

    Article  PubMed  Google Scholar 

  • Basson, R., Althof, S., Davis, S., Fugl-Meyer, K, Goldstein, I., Leiblum, S., et al. (2004). Summary of the recommendations on sexual dysfunctions in women. Journal of Sexual Medicine, 1, 24–34.

    Article  PubMed  Google Scholar 

  • Basson, R., Berman, J., Burnett, A., Derogatis, L., Ferguson, D., Fourcroy, J., et al. (2000). Report of the International Consensus Development Conference on Female Sexual Dysfunction: Definitions and classifications. Journal of Urology, 163, 888–893.

    Article  PubMed  CAS  Google Scholar 

  • Beckman, L. J., & Ackerman, K. T. (1995). Women, alcohol, and sexuality. Recent Developments in Alcoholism, 12, 267–285.

    Article  PubMed  CAS  Google Scholar 

  • Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., et al. (2003). Development of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse and Neglect, 27, 169–190.

    Article  PubMed  Google Scholar 

  • Bonierbale, M., Lancon, C., & Tignol, J. (2003). The ELIXIR study: Evaluation of sexual dysfunction in 4557 depressed patients in France. Current Medical Research and Opinion, 19, 114–124.

    Article  PubMed  Google Scholar 

  • Çayan, S., Bozlu, M., Canpolat, B., & Akbay, E. (2004). The assessment of sexual functions in women with male partners complaining of erectile dysfunction: Does treatment of male sexual dysfunction improve female partner’s sexual functions. Journal of Sex and Marital Therapy, 30, 333–341.

    Article  PubMed  Google Scholar 

  • Covington, S. S., & Kohen, J. (1984). Women, alcohol, and sexuality. Advances in Alcohol and Substance Abuse, 4, 41–56.

    PubMed  CAS  Google Scholar 

  • Daker-White, G. (2002). Reliable and valid self-report outcome measures in sexual (dys)function: A systematic review. Archives of Sexual Behavior, 31, 197–209.

    Article  PubMed  Google Scholar 

  • Derogatis, L. R. (2001). Brief Symptom Inventory-18 (BSI-18): Administration, scoring, and procedures manual. Minneapolis: NCS Pearson.

    Google Scholar 

  • Dunn, K. M., Croft, P. R., & Hackett, G. (1999). Association of sexual problems with social, psychological, and physical problems in men and women: A cross sectional survey. Journal of Epidemiology and Community Health, 53, 144–148.

    Article  PubMed  CAS  Google Scholar 

  • Dunne, M. P., Martin, N. G., Bailey, J. M., Heath, A. C., Bucholz, K. K., Madden, P. A. F., et al. (1997). Participation bias in a sexuality survey: Psychological and behavioral characteristics of responders and non-responders. International Journal of Epidemiology, 26, 844–854.

    Article  PubMed  CAS  Google Scholar 

  • Figueira, I., Possidente, E., Marques, C., & Hayes, K. (2001). Sexual dysfunction: A neglected complication of panic disorder and social phobia. Archives of Sexual Behavior, 30, 369–377.

    Article  PubMed  CAS  Google Scholar 

  • Frohlich, P., & Meston, C. (2002). Sexual functioning and self-reported depressive symptoms among college women. Journal of Sex Research, 39, 321–325.

    PubMed  Google Scholar 

  • Fugl-Meyer, K. S., & Fugl-Meyer, A. R. (2002). Sexual disabilities are not singularis. International Journal of Impotence Research, 14, 487–493.

    Article  PubMed  CAS  Google Scholar 

  • George, W. H., & Stoner, S. A. (2000). Understanding alcohol and sexual behavior. Annual Review of Sex Research, 11, 125–157.

    Google Scholar 

  • Graham, C. A., Ramos, R., Bancroft, J., Maglaya, C., & Farley, T. M. M. (1995). The effects of steroidal contraceptives of the well-being and sexuality of women: A double-blind, placebo-controlled, two-centre study of combined and progesterone-only methods. Contraception, 52, 363–369.

    Article  PubMed  CAS  Google Scholar 

  • Graham, C. A., Sanders, S. A., Milhausen, R. R., & McBride, K. R. (2004). Turning on and turning off: A focus group study of the factors that affect women’s sexual arousal. Archives of Sexual Behavior, 33, 527–538.

    Article  PubMed  Google Scholar 

  • Gruszecki, L., Forchuk, C., & Fisher, W. A. (2005). Factors associated with common sexual concerns in women: New findings from the Canadian contraceptive study. Canadian Journal of Human Sexuality, 14, 1–13.

    Google Scholar 

  • Heiman, J. R. (2001). Sexual desire in human relationships. In W. Everaerd, E. Laan, & S. Both (Eds.), Sexual appetite, desire and motivation: Energetics of the sexual system (pp. 117–134). Amsterdam: Royal Netherlands Academy.

    Google Scholar 

  • Helweg-Larsen, K., & Bøving Larsen, H. (2002). Unges trivsel år 2002. En undersøkelse med fokus på seksuelle overgreb i barndommen. København: Statens Institut for Folkesundhed.

    Google Scholar 

  • Johnson, S. D., Phelps, D. L., & Cottler, L. B. (2004). The association of sexual dysfunction and substance use among a community epidemiological sample. Archives of Sexual Behavior, 33, 55–63.

    Article  PubMed  Google Scholar 

  • Kadri, N., Alami, K. H. M., & Tahiri, S. M. (2002). Sexual dysfunction in women: Population based epidemiological study. Archives of Women’s Mental Health, 5, 59–63.

    Article  PubMed  CAS  Google Scholar 

  • Kendler, K. S., Martin, N. G., Heath, A. C., & Eaves, L. J. (1995). Self-report psychiatric symptoms in twins and their non-twin relatives: Are twins different? American Journal of Medical Genetics, 60, 588–591.

    Article  PubMed  CAS  Google Scholar 

  • Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. Journal of the American Medical Association, 281, 537–544.

    Article  PubMed  CAS  Google Scholar 

  • Leonard, L. M., & Follette, V. M. (2002). Sexual functioning in women reporting a history of child sexual abuse: Review of the empirical literature and clinical implications. Annual Review of Sex Research, 13, 346–387.

    PubMed  Google Scholar 

  • Lewis, R. W., Fugl-Meyer, K. S., Bosch, R., Fugl-Meyer, A. R., Laumann, E. O., Lizza, E., et al. (2004). Epidemiology/risk factors of sexual dysfunction. Journal of Sexual Medicine, 1, 35–39.

    Article  PubMed  Google Scholar 

  • Li, R. H. W., Lo, S. S. T., Teh, D. K. G., Tong, N.-C., Tsui, M. H. Y., Cheung, K-B., et al. (2004). Impact of common contraceptive methods on quality of life and sexual function in Hong Kong Chinese women. Contraception, 70, 474–482.

    Article  PubMed  Google Scholar 

  • Loeb, T. B., Williams, J. K., Carmona, J. V., Rivkin, I., Wyatt, G. E., Chin, D., et al. (2002). Child sexual abuse: Associations with the sexual functioning of adolescents and adults. Annual Review of Sex Research, 13, 307–345.

    PubMed  Google Scholar 

  • Långström, N., & Zucker, K. J. (2005). Transvestic fetishism in the general population: Prevalence and correlates. Journal of Sex and Marital Therapy, 31, 87–95.

    Article  PubMed  Google Scholar 

  • Masheb, R. M., Lozano-Blanco, C., Kohorn, E. I., Minkin, M. J., & Kerns, R. D. (2004). Assessing sexual function and dyspareunia with the Female Sexual Function Index (FSFI) in women with vulvodynia. Journal of Sex and Marital Therapy, 30, 315–324.

    Article  PubMed  Google Scholar 

  • McCoy, N. L., & Matyas, J. R. (1996). Oral contraceptives and sexuality in university women. Archives of Sexual Behavior, 25, 73–90.

    Article  PubMed  CAS  Google Scholar 

  • Meston, C. M. (2003). Validation of the Female Sexual Function Index (FSFI) in women with female orgasmic disorder and in women with hypoactive sexual desire disorder. Journal of Sex and Marital Therapy, 29, 39–46.

    Article  PubMed  Google Scholar 

  • Mulaik, S. A., James, L. R., Van Alstine J., Bennett, N., Lind, S., & Stilwell, C. D. (1989). Evaluation of goodness-of-fit indices for structural equation models. Psychological Bulletin, 105, 430–445.

    Article  Google Scholar 

  • Mustanski, B. S., Viken, R., Kaprio, J., Winter, T., & Rose, R. J. (2007). Sexual behavior in young adulthood: A population-based twin study. Health Psychology, 26, 610–617.

    Article  PubMed  Google Scholar 

  • Najman, J. M., Dunne, M. P., Purdie, D. M., Boyle, F. M., & Coxeter, P. D. (2005). Sexual abuse in childhood and sexual dysfunction in adulthood: An Australian population-based study. Archives of Sexual Behavior, 34, 517–526.

    Article  PubMed  Google Scholar 

  • Nobre, P. J., Pinto-Gouveia, J., & Gomes, F. A. (2006). Prevalence and comorbidity of sexual dysfunctions in a Portuguese clinical sample. Journal of Sex and Marital Therapy, 32, 73–182.

    Article  Google Scholar 

  • Ponholzer, A., Roehlich, M., Racz, U., Temml, C., & Madersbacher, S. (2005). Female sexual dysfunction in a healthy Austrian cohort: Prevalence and risk factors. European Urology, 47, 366–375.

    Article  PubMed  Google Scholar 

  • Pulkkinen, L., Vaalamo, I., Hietala, R., Kaprio, J., & Rose, R. J. (2003). Peer reports of adaptive behavior in twins and singletons: Is twinship a risk or an advantage? Twin Research, 6, 106–118.

    Article  PubMed  Google Scholar 

  • Rellini, A. H., & Meston, C. M. (2006). Psychophysiological sexual arousal in women with a history of child sexual abuse. Journal of Sex and Marital Therapy, 32, 5–22.

    Article  PubMed  Google Scholar 

  • Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsig, R., et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26, 191–208.

    Article  PubMed  CAS  Google Scholar 

  • Salonia, A., Munarriz, R. M., Naspro, R., Nappi, R. E., Briganti, A., Chionna, R., et al. (2004). Women’s sexual dysfunction: A pathophysiological review. British Journal of Urology International, 93, 1156–1164.

    CAS  Google Scholar 

  • Salonia, A., Nappi, R. E., Pontillo, M., Daverio, R., Smeraldi, A., Briganti, A., et al. (2005). Menstrual cycle-related changes in plasma oxytocin are relevant to normal sexual function in healthy women. Hormones and Behavior, 47, 164–169.

    Article  PubMed  CAS  Google Scholar 

  • Sariola, H., & Uutela, A. (1994). The prevalence of child sexual abuse in Finland. Child Abuse & Neglect, 18, 825–833.

    Article  Google Scholar 

  • Seal, B. N., Brotto, L. A., & Gorzalka, B. B. (2005). Oral contraceptive use and female genital arousal: Methodological considerations. Journal of Sex Research, 42, 249–258.

    Article  PubMed  Google Scholar 

  • Shokrollahi, P., Mirmohamadi, M., Mehrabi, F., & Babaei, G. (1999). Prevalence of sexual dysfunction in women seeking services at family planning centers in Tehran. Journal of Sex and Marital Therapy, 25, 211–215.

    PubMed  CAS  Google Scholar 

  • Simons, J. S., & Carey, J. P. (2001). Prevalence of sexual dysfunctions: Results from a decade of research. Archives of Sexual Behavior, 30, 177–219.

    Article  PubMed  CAS  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics. Boston: Allyn and Bacon.

    Google Scholar 

  • Thompson, B. (2004). Exploratory and confirmatory factor analysis: Understanding concepts and applications. Washington, DC: American Psychological Association.

    Google Scholar 

  • Van den Oord, E. J. C. G., Pickles, A., & Waldman, I. D. (2003). Normal variation and abnormality: An empirical study of the liability distributions underlying depression and delinquency. Journal of Child Psychology and Psychiatry, 44, 180–192.

    Article  PubMed  Google Scholar 

  • Wiegel, M., Meston, C., & Rosen, R. (2005). The Female Sexual Function Index (FSFI): Cross-validation and development of clinical cutoff scores. Journal of Sex and Marital Therapy, 31, 1–20.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was financed by Grant No. 210298 from the Academy of Finland and a Centre of Excellence Grant from the Stiftelsen för Åbo Akademi Foundation. We want to thank the anonymous reviewers and the Editor for their valuable comments. We also want to thank the participating twins.

Author information

Authors and Affiliations

  1. Centre of Excellence for Behavior Genetics, Department of Psychology, Åbo Akademi University, 20500, Turku, Finland

    Katarina Witting, Pekka Santtila, Patrick Jern, Markus Varjonen, Ingrid Wager, Maria Höglund, Ada Johansson, Nina Vikström & N. Kenneth Sandnabba

Authors
  1. Katarina Witting
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pekka Santtila
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patrick Jern
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Markus Varjonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ingrid Wager
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria Höglund
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ada Johansson
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Nina Vikström
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. N. Kenneth Sandnabba
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katarina Witting.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Witting, K., Santtila, P., Jern, P. et al. Evaluation of the Female Sexual Function Index in a Population Based Sample from Finland. Arch Sex Behav 37, 912–924 (2008). https://doi.org/10.1007/s10508-007-9287-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-007-9287-8

Keywords

Search

Navigation