Introduction
Humans have many desires that make their identity and personality. Their timely and adequate satisfaction has a significant effect on their physical and mental health. One of these desires is sexual desire. The basis of the family is based on sexual desire. This desire is a good feeling that drives men and women towards marriage and building families. By sexual satisfaction, a person can reach peace in mind, in addition to meeting physical needs [
1,
2]. Mindfulness is usually defined as a state of awareness and attention to what is happening in the present moment [
6]. Researchers have shown that high mindfulness is related to various health outcomes such as reduced pain, anxiety, depression, unhealthy eating behaviors, and stress [
6, 7]. Mindfulness can help free people from automatic thoughts, unhealthy habits and behavioral patterns, and thus plays an important role in regulating behavioral processes [
1,
6].
According to some reports from clinical studies, the important role of attention and concentration in women’s arousal and orgasm cycles, can emphasize the effectiveness of therapeutic methods based on mindfulness in reducing sexual dysfunctions and improving the quality of orgasm. Some evidence suggests that mindfulness skills reduce women’s sexual anxiety, and women probably experience orgasm more consciously in such conditions, which may lead to its qualitative improvement [
2,
7]. On the other hand, since mindfulness interventions are usually performed in group, it seems that they can lead to reduced treatment costs and better time efficiency [
6, 7]. The present study aims to investigate the effectiveness of sexual therapy based on mindfulness on indicators of orgasm quality and sexual function in women with orgasmic disorder. This method was designed using mindfulness-based stress reduction method and Masters and Johnson’s model of sex therapy.
Methods
This is a clinical trial. The study population consists of Iranian married women referred to the clinics of family therapy, sex therapy, and psychiatry in Tehran, Iran. After obtaining informed consent, 25 participants were interviewed and completed the Symptom Checklist-90 (SCL90) where items are rated on a scale from 0 to 4. The total score should not be less than the cut-off point. Then, the sexual function questionnaire and a researcher-made questionnaire on orgasm quality were completed by all participants. The sexual function questionnaire with 19 questions measures women’s sexual function in 6 areas of sexual desire, arousal, moisture, orgasm, satisfaction and sexual pain. We used its Persian version whose validity has already been approved in other study. The researcher-made orgasm quality questionnaire measures the frequency of sexual intercourse in the past month, the frequency of orgasm in the past month in relation to the number of sexual intercourses, and self-assessment of orgasm quality. Demographic information, general health conditions, and relationship-related information were obtained through self-report. Then, they received education about the structure of sexual system and sexual response processes. After that, the mindfulness-based sex therapy protocol was presented at 8 sessions. The questionnaires were completed again immediately after and three months after the treatment program.
Results
The mean age of 25 participants was 39.48±6.40 years. Their mean years of education was 17.08±1.14 years. Fifteen women (60%) were employed, all of them had master’s degree or higher. The mean scores of participants are presented in
Table 1.
![](./files/site1/images/28-4/2/T1.jpg)
In comparing sexual function, orgasm quality, symptoms of female orgasmic disorder, and number of sexual intercourses per month (
Table 2), the results showed an increase in sexual function and indicators of orgasm quality immediately after and three months after the intervention.
![](./files/site1/images/28-4/2/T2.jpg)
Compared to the results recorded before the intervention, the mindfulness-based intervention increased the scores, and the interaction effect of treatment and time showed was significant. Multivariate analysis of variance showed a significant difference in sexual function (Wilks’ Lambda=0.05, F(2, 22)=195.95, P<0.0001, η2=0.947), symptoms of female orgasmic disorder (Wilks’ Lambda=0.31, F(2,22)=330.97, P<0.0001, η2=0.969), orgasm experience quality (Wilks’ Lambda=0.29, F(2, 22)=352.28, P<0.0001, η2=0.971) and number of sexual intercourses per month (Wilks’ Lambda=0.05, F(2, 22)=183.15, P<0.0001, η2=0.946) over time. The pairwise comparison of times showed that the difference in the study variables between the times “immediately after the intervention” and “three months after the intervention” was statistically significant, compared to the pre-intervention period (P<0.05).
Discussion
It seems that mindfulness-based sex therapy is effective in improving sexual function and orgasm quality in women with orgasmic disorder.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1399.1018) and was registered by Iranian Registry of Clinical Trials (ID: IRCT20180310039024N2).
Funding
This study was extracted from the doctoral thesis of the first author in clinical psychology approved by Islamic Azad University of Shiraz branch. This study was not funded by any organizations.
Authors contributions
The authors contributed equally to preparing this paper.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors would like to thank the participants for their cooperation.
References
- Bagherzadeh R, Sohrabineghad R, Gharibi T, Mehboodi F, Vahedparast H. Effect of mindfulness-based stress reduction training on revealing sexual function in Iranian women with breast cancer. Sexuality and Disability. 2021; 39(1):67-83. [DOI:10.1007/s11195-020-09660-1]
- Johnson SM, Simakhodskaya Z, Moran M. Addressing issues of sexuality in couples therapy: Emotionally focused therapy meets sex therapy. Current Sexual Health Reports. 2018; 10(2):65-71. [Link]
- Hamid N, Dehghanizadeh Z, Firuzi AA. [Effects of cognitive-behavioral therapy on sexual function in women with vaginismus disorder (Persian)]. Iranian Journal of Obstetrics, Gynecology and Infertility. 2012; 15(20):1-11. [Link]
- Abedi Shargh N, Bakhshani NM, Mohebbi MD, Mahmudian K, Ahovan M, Mokhtari M, et al. The effectiveness of mindfulness-based cognitive group therapy on marital satisfaction and general health in woman with infertility. Global Journal of Health Science. 2015; 8(3):230-5. [DOI:10.5539/gjhs.v8n3p230] [PMID] [PMCID]
- Kajbaf M. [The effectiveness of cognitive-behavioral therapy on the sexual temperament of Afghan women (employed and educated in Iranian universities) (Persian)]. Family and Sexual Health. 2021; 2(1):17-28. [DOI:10.52547/fash.2.1.17]
- Brown KW, Ryan RM. The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology. 2003; 84(4):822-48. [DOI:10.1037/0022-3514.84.4.822] [PMID]
- Adam F, Géonet M, Day J, De Sutter P. Mindfulness skills are associated with female orgasm? Sexual and Relationship Therapy. 2015; 30(2):256-67. [DOI:10.1080/14681994.2014.986085]
- Smedley DK, Leavitt CE, Allsop DB, Nance M, James SL, Holmes EK. Mindfulness and sexual mindfulness as moderators between conflict resolution and sexual and relationship satisfaction. Journal of Sex & Marital Therapy. 2021; 47(8):814-28. [DOI:10.1080/0092623X.2021.1958962] [PMID]
- Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist. 2000; 55(1):68-78. [DOI:10.1037/0003-066X.55.1.68] [PMID]
- Sheybani F, Dabaghi P, Najafi S, Rajaeinejad M. [Effectiveness of Mindfulness-Based Stress Reduction (MBSR) on pain intensity, anxiety, depression and quality of life of patients with chronic pain (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2022; 28(2):182-95. [DOI:10.32598/ijpcp.28.2.1627.2]
- Jaderek I, Lew-Starowicz M. A systematic review on mindfulness meditation-based interventions for sexual dysfunctions. The Journal of Sexual Medicine. 2019; 16(10):1581-96. [DOI:10.1016/j.jsxm.2019.07.019] [PMID]
- Kabat-Zinn J. Mindfulness for beginners. In: Schwartz DG, editor. Reclaiming the present moment-and your life. Colorado: Sounds True; 2012. [Link]
- Kabat-Zinn J. Mindfulness. Mindfulness. 2015; 6(6):1481-3. [Link]
- Park T, Reilly-Spong M, Gross CR. Mindfulness: A systematic review of instruments to measure an emergent patientreported outcome (PRO). Quality of Life Research. 2013; 22(10):2639-59.[DOI:10.1007/s11136-013-0395-8] [PMID] [PMCID]
- Visted E, Vøllestad J, Nielsen MB, Nielsen GH. The impact of group-based mindfulness training on self-reported mindfulness: A systematic review and meta-analysis. Mindfulness. 2015; 6(3):501-22. [Link]
- Chiesa A, Serretti A. Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis. Psychiatry Research. 2011; 187(3):441-53. [DOI:10.1016/j.psychres.2010.08.011] [PMID]
- Hosein Esfand Zad A, Shams G, Pasha Meysami A, Erfan A. [The role of mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness in predicting obsessive-compulsive symptoms (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2017; 22(4):270-83. [DOI:10.18869/nirp.ijpcp.22.4.270]
- Fjorback LO, Arendt M, Ornbøl E, Fink P, Walach H. Mindfulness-based stress reduction and mindfulness-based cognitive therapy: A systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica. 2011; 124(2):102-19. [DOI:10.1111/j.1600-0447.2011.01704.x] [PMID]
- Warne RT. A primer on multivariate analysis of variance (MANOVA) for behavioral scientists. Practical Assessment, Research & Evaluation. 2014; 19(17):1-10. [Link]
- Stevens JP. Applied multivariate statistics for the social sciences. New York: Routledge; 2012. [DOI:10.4324/9780203843130]
- Carson JW, Carson KM, Gil KM, Baucom DH. Mindfulness-based relationship enhancement (MBRE) in couples. In: Baer RA, editor. Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications. Elsevier Science; 2015. [Link]
- Farajkhoda T, Sohran F, Molaeinezhad M, Fallahzadeh H. The effectiveness of mindfulness-based cognitive therapy consultation on improving sexual satisfaction of women in reproductive age: A clinical trial study in Iran. Journal of Advanced Pharmacy Education & Research. 2019; 9(S2):151-60. [Link]
- Fard R, Kalantarkousheh M, Faramarzi M. Effect of mindfulness-based cognitive infertility stress therapy on psychological well-being of women with infertility. Middle East Fertility Society Journal. 2018; 23(4):476-81. [DOI:10.1016/j.mefs.2018.06.001]
- Helgadóttir FD, Menzies RG, Onslow M, Packman A, O’Brian S. A standalone Internet cognitive behavior therapy treatment for social anxiety in adults who stutter: CBTpsych. Journal of Fluency Disorders. 2014; 41:47-54. [DOI:10.1016/j.jfludis.2014.04.001]
- Helgadóttir FD. Internet-based mindfulness therapy for social anxiety and negative future thoughts in adults with stuttering. Journal of Fluency Disorders. 2019; 12:241-59.
- Moghadam NK, Kazerooni G. A study of mindfulness-based stress reduction’s effectiveness on marital satisfaction in women. International Journal of Health Studies. 2017; 3(1):1-4. [Link]
- Bakhtiari M, Sheydaei H, Bahreynian SA, Nori M. [The effect of cognitive-behavioral therapy on sexual desire and marital satisfaction (Persian)]. Journal of Behavioral Thought. 2014; 9(36):7-16. [Link]
- Mauvais-Jarvis F, Merz NB, Barnes PJ, Brinton RD, Carrero JJ, DeMeo DL, et al. Sex and gender: Modifiers of health, disease, and medicine. The Lancet. 2020; 396(10250):565-82. [DOI:10.1016/S0140-6736(20)31561-0]
- Brotto LA, Heiman JR. Mindfulness in sex therapy: Applications for women with sexual difficulties following gynecologic cancer. Sexual and Relationship Therapy. 2007; 22(1):3-11. [DOI:10.1080/14681990601153298]