Psychometric Properties of the Iranian Version of the Female Sexual Distress Scale-Revised in Women Elham Azimi Nekoo, MD,* Andrea Burri, MSc, † Farzaneh Ashrafti, MSc, ‡ Bengt Fridlund, PhD, § Harold G. Koenig, MD, ¶ ** Leonard R. Derogatis, PhD, †† and Amir H. Pakpour, PhD ‡‡§§ *Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran; † Department of Psychology, University of Zurich, Zurich, Switzerland; ‡ Neurology Research Center and Department of Midwifery, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran; § School of Health Sciences, Jönköping University, Jönköping, Sweden; ¶ Departments of Medicine and Psychiatry, Duke University Medical Center, Durham, NC, USA; **Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; †† Center for Sexual Medicine at Sheppard Pratt and Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA; ‡‡ Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran; §§ Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran DOI: 10.1111/jsm.12449 ABSTRACT Introduction. Several tools for the assessment of sexuality-related distress are now available. The Female Sexual Distress Scale (FSDS) and its revised version (FSDS-R) are extensively validated and among the most widely used tools to measure sexually related personal distress. Aim. The aim of the study was to determine the psychometric properties of the Iranian version of the FSDS-R in a population sample of Iranian women. Methods. A total of 2,400 married and potentially sexually active women were recruited and categorized into three groups including (i) a healthy control group; (ii) a group of women with hypoactive sexual desire disorder (HSDD); and (iii) a group of women suffering from other female sexual dysfunction (FSD). Participants were asked to complete a set of questionnaires including the Iranian version of the Female Sexual Function Index (FSFI-IV), the FSDS-R, and the Hospital Anxiety and Depression Scale. Main Outcome Measures. Sexuality-related distress and FSD as assessed by the Iranian version of the FSDS-R and the FSFI-IV are the main outcome measures. Results. Internal consistencies and test–retest reliability of the FSDS-R across the three assessments points for the three groups were >0.70. The FSDS-R correlated significantly with anxiety, depression, and the FSFI total score. Significant differences in the FSDS-R scores were found between healthy women, women with HSDD, and women with other types of FSD. Factor analysis of the FSDS-R yielded a single-factor model with an acceptable fit. Conclusions. The Persian version of the FSDS-R is a valid and reliable instrument for the assessment of sexuality- related distress in Iranian women and can be used to screen patients with HSDD. Azimi Nekoo E, Burri A, Ashrafti F, Fridlund B, Koenig HG, Derogatis LR, and Pakpour AH. Psychometric properties of the Iranian version of the Female Sexual Distress Scale-Revised in women. J Sex Med **;**:**–**. Key Words. Female Sexual Distress Scale-Revised; Iranian Version; Sexually Related Personal Distress; Psychometrics Introduction F emale sexual dysfunction (FSD) refers to the various ways in which a woman is unable to participate in a sexual relationship or experience sexuality the way she would wish [1]. According to current classification systems, FSD includes disor- ders of sexual desire, arousal, orgasm, and pain [2]. Prevalences of up to 50% for female sexual complaints have been reported, with estimates dif- 1 © 2014 International Society for Sexual Medicine J Sex Med **;**:**–**