Awareness, Attitudes, and Acceptability of the Female Sexual Function Index (FSFI) Among Women in Sri Lanka: A Cross-sectional Study

Introduction: The Female Sexual Function Index (FSFI) is used to assess female sexual function, but limited data exists on patient perceptions of, and potential stigma associated with completing the questionnaire.

Objectives: To evaluate patient awareness, attitudes, and perceived stigma related to completing the Sinhala version of the FSFI among patients admitted to the Professorial Gynaecology wards of the Teaching Hospital, Peradeniya.

Methods: A descriptive cross-sectional study was conducted among 139 sexually active women, irrespective of ethnicity, who were literate in Sinhala and provided informed written consent. Participants completed the FSFI, which was developed using standard forward–backward translation, with content and cultural validation by an expert panel comprising an obstetrician, a psychiatrist, and a community physician, and a separate anonymous questionnaire assessing sexual education, awareness, comfort
level, and perceptions toward the FSFI. Data were analysed using SPSS Version 23.

Results: The mean age of the cohort was 34.5 years (SD: 5.86). Most participants (79.9%) believed that discussing female sexual function is necessary, and 82.0% viewed a healthy sexual relationship as essential for overall well-being. 66.2% rated the questionnaire as very useful. Most respondents (63.3%) felt that using such a questionnaire is appropriate in Sri Lanka. A total of 74.8% did not feel uneasy when completing the FSFI. Healthcare workers were identified as the preferred method for assessing female
sexual concerns. Overall, 25.05% of all response cells were left blank.

Conclusion: It was concluded that the participants’ perception of FSFI was generally positive. The majority identified it as a useful, culturally appropriate tool to discuss female sexual function. However, findings also highlight the need for improved sexual education among Sri Lankans.