Detailed definition
The Female Sexual Distress Scale-Revised (FSDS-R) measures the personal distress component of female sexual dysfunction. The original FSDS was developed by Derogatis in 2002 and revised to add an item specifically about decreased desire (FSDS-R, 2008; FSDS-DAO is a further revision). Items are rated 0 (never) to 4 (always) for the past 30 days. A total score ≥11 indicates clinically significant sexual distress. FSDS-R is used in HSDD clinical trials and is a recommended screening tool by the International Society for the Study of Women's Sexual Health (ISSWSH).
Why it matters in menopause
Distress is what makes low desire or arousal a clinical problem. The FSDS-R helps separate women who have lower-than-average sexual function but are not bothered (no diagnosis, no treatment needed) from those experiencing meaningful suffering (treatment is appropriate). For postmenopausal women presenting with sexual concerns, this distinction is essential.