Cognitive behavioral therapy may improve sexual function for menopausal women
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Key takeaways:
- A cognitive behavioral therapy protocol improved symptoms of decreased sexual desire.
- Women also reported improved depression and anxiety symptoms, body image and couple satisfaction.
CHICAGO — Menopausal women who participated in weekly cognitive behavioral therapy sessions reported improvements in sexual function and depression and anxiety symptoms, researchers reported at the Annual Meeting of The Menopause Society.
Hormone therapy remains the most effective and most common treatment for sexual concerns in postmenopausal women, according to Sheryl M. Green, PhD, CPsych, associate professor in the department of psychiatry and behavioral neurosciences, co-director of clinical training in the department of psychology, neuroscience and behavior at McMaster University and clinical and health psychologist at the Women’s Health Concerns Clinic and Firestone Sleep Medicine Clinic at St. Joseph’s Healthcare in Canada.
“However, not every woman is a good candidate for this type of treatment because of contraindications or personal preferences; not everyone wants to take medication for sexual concerns, and then another important consideration is that a lot of people who are on hormone therapy and other medications are still experiencing significant clinical distress and dysfunction related to sexual concerns in spite of taking the medication,” Green said during the presentation. “There is a need for a nonpharmacological treatment option as an alternative or complementary form of treatment.”
Green and colleagues conducted a clinical trial with 30 peri- or postmenopausal women who experienced primary sexual concerns and reported a score of 26.55 or lower on the Female Sexual Function Index, indicating decreased sexual functioning. Participants were assigned to a waitlist for 4 weeks (control condition) followed by four individual cognitive behavioral therapy (CBT) protocol sessions specifically aimed to improve sexual satisfaction and reduce distress during menopause. At baseline, post-waitlist and posttreatment, participants completed measurements assessing sexual satisfaction, distress and desire, menopause symptoms, body image, relationship satisfaction, depression and anxiety. After the protocol, participants also completed the Client Satisfaction Questionnaire.
Researchers observed no significant changes across all measures during the waitlist period, except for the Female Sexual Desire Questionnaire concern subscale and the Greene Climacteric Scale physical subscale. After the weekly CBT sessions, participants reported decreases in symptoms of sexual distress, concern and resistance, menopause symptoms, depression and anxiety symptoms and improved body image and couple satisfaction (P < .05 for all).
All participants indicated the CBT protocol helped them cope with symptoms more effectively.
“What we would like to do next is employ a randomized controlled trial design with an active comparison condition, have a large sample, recruit diverse participants, have a long-term follow-up and engage in some qualitative design methods,” Green said.