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

New England Research Institutes, Inc., Watertown, MA 02472, USA.
Journal of Sexual Medicine (Impact Factor: 3.15). 09/2010; 7(9):3096-103. DOI: 10.1111/j.1743-6109.2010.01871.x
Source: PubMed

ABSTRACT 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.
This article defines and validates a specific cutpoint on the SD domain for differentiating women with and without hypoactive sexual desire disorder (HSDD).
Eight datasets (618 women) were included in the development dataset. Four independent datasets (892 women) were used in the validation portion of the study.
Diagnosis of HSDD was clinician-derived. Receiver-operator characteristic (ROC) curves were used to develop the cutpoint, which was confirmed in the validation dataset.
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.
These analyses support the diagnostic accuracy of the SD domain for use in future observational studies and clinical trials of HSDD.


Available from: Michael Sand, Feb 13, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study used a mixed methods approach to investigate the intimate world of men’s sexual problems in Portugal, and particularly erectile dysfunction, focusing on the interplay between individual, societal and relational factors. First, a community-based survey was designed, with 323 primary health care users, to investigate how sociocultural factors influence experiences and representations of sexual problems. Second, a qualitative study, involving in-depth interviews with a subsample of ten heterosexual men, complemented by five heterosexual women’s narratives, concerning men’s sexual problems, was carried out to understand the meaning of sexual problems from a lay perspective. Statistical analysis of quantitative data was carried out through logistic regressions to evaluate the sociodemographic predictors of lay representations of sexual problems. Qualitative data were analyzed using an empirically grounded typology. The role of individuals in the construction of sexual dysfunctions, particularly erectile dysfunction, was explored using sexual script theory. Key findings revealed the impact of sexual problems on daily life. Gender analysis results contributed to the understanding of how men and women challenge the definition of sexual problems as normal changes versus dysfunctional changes. Specific patterns of change in sexual experiences and sexual problems were identified in the Portuguese gendered society, which can possibly be applied to other nations and cultures.
    Sexuality & Culture 01/2015; DOI:10.1007/s12119-015-9276-3
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: IntroductionHuman asexuality is defined as a lack of sexual attraction to anyone or anything. Various theories have been proposed to explain how asexuality should best be classified, and some have maintained that asexuality is an extreme variant of hypoactive sexual desire disorder (HSDD)—a sexual dysfunction characterized by a lack of interest in sex and significant distress. To date, this has never been empirically examined.Aim and Method Using measures of sexual desire and behavior, sex-related distress, personality, and psychopathology, the aim of the current study was to compare individuals scoring above the cutoff for asexuality identification (AIS >40) (n = 192) to sexual individuals (n = 231). The sexual group was further divided into a control group (n = 122), a HSDD group (n = 50), and a group with symptoms of low desire that were nondistressing (n = 59).ResultsAnalyses were controlled for age. Individuals in the AIS >40 group had a greater likelihood of never previously engaging in sexual intercourse, fantasies, or kissing and petting than all other groups and a lower likelihood of experiencing sex-related distress than those with HSDD. For women, those in the HSDD and AIS >40 groups had significantly lower desire than the subclinical HSDD and control groups. Men in the AIS >40 group had significantly lower desire than the other three groups. Symptoms of depression were highest among those with subclinical HSDD and HSDD, whereas there were no group differences on alexithymia or desirable responding. A binary logistic regression indicated that relationship status (long-term dating/married), sexual desire, sex-related distress, and lower alexithymia scores were the best predictors of group membership (HSDD vs. AIS >40).Conclusion Taken together, these results challenge the speculation that asexuality should be classified as a sexual dysfunction of low desire. Brotto LA, Yule MA, and Gorzalka BB. Asexuality: An extreme variant of sexual desire disorder? J Sex Med **;**:**–**.
    Journal of Sexual Medicine 03/2015; 12(3). DOI:10.1111/jsm.12806 · 3.15 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although sexual functioning is an important facet of living donor quality of life, it has not received extensive evaluation in this population. Using data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study, we examined donor sexual functioning across the donation process from the predonation evaluation to 3 months and 1 year postdonation. Donors (n=208) and a comparison group of non-donors (n=155) completed self-reported surveys with specific questions on sexual desire, satisfaction, orgasm, and (for men) erectile function. Across the three time points, donor sexual functioning was lower at the evaluation phase and 3 months postdonation than at one year postdonation. In the early recovery period, abdominal pain was associated with difficulty reaching orgasm (OR = 3.98, 95% CI 1.30-12.16), concerns over appearance with lower sexual desire (OR = 4.14, 95% CI 1.02-16.79), and not feeling back to normal was associated with dissatisfaction with sexual life (OR 3.58, 95% CI 1.43-8.99). Efforts to educate donors before the surgery and prepare them for the early recovery phase may improve recovery and reduce distress regarding sexual functioning. This article is protected by copyright. All rights reserved. © 2015 American Association for the Study of Liver Diseases.
    Liver Transplantation 03/2015; 21(5). DOI:10.1002/lt.24108 · 3.79 Impact Factor