Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran 1416634793, Iran.
J Sex Med. 2024 Jan 30;21(2):153-162. doi: 10.1093/jsxmed/qdad168.
Female sexual interest/arousal disorder (FSIAD) is the most common female sexual disorder with adverse effects on women's health and interpersonal relationships.
This survey evaluated the effects of sexual counseling based on the "good enough sex" (GES) model on the sexual health variables of women with FSIAD.
A randomized clinical trial with a 1:1 allocation ratio was conducted among 80 women with FSIAD in Iran in 2021. Eligible participants were randomly assigned to group A (women) and group B (couples). Women attended 4 weekly online group sexual counseling sessions based on the GES model, each lasting 120 minutes. In group B, husbands participated in sessions 2 and 3.
Women's sexual health parameters-including sexual desire, sexual satisfaction, sexual function, sexual distress, sexual communication, frequency of sexual intercourse, and dysfunctional beliefs-were evaluated before and 3 months after counseling. The significance threshold considered P < .007 due to Bonferroni correction.
After the intervention, all sexual parameters except sexual dysfunctional beliefs showed significant improvement (P < .001) in both groups. During the follow-up period, the average scores for all sexual variables were slightly higher in group B vs group A. The between-group difference was significant only for frequency of sexual intercourse (P < .01).
This study reaffirms the impact of the GES model as biopsychosocial therapy in managing female sexual problems. Considering men's reluctance to accompany their wives to sex clinics, counseling for women alone can play a significant role in solving sexual problems, especially in the case of FSIAD. Online sexual consultation offers cost and time savings, provides a secure space for discussing sensitive topics, and facilitates group program coordination. It ensures universal access to counseling, thereby addressing gender incompatibility issues. It is a powerful, interactive, and acceptable alternative to in-person visits, providing convenience and confidentiality for clients seeking sexual health support.
The following were among the survey strengths: conducting a randomized controlled trial on women with FSIAD by applying an appropriate model and scales, involving spouses, and evaluating online group sexual counseling. However, the results of this study may not be generalizable to women without partners.
The GES model, emphasizing intimacy and sexual dialogue, reduces unrealistic sexual expectations and improves women's sexual desire and overall health. Our results showed that instead of insisting on the physical presence of husbands in counseling sessions, clinicians should emphasize their emotional support and companionship during the treatment process.
女性性兴趣/唤起障碍（FSIAD）是最常见的女性性障碍，对女性的健康和人际关系有不良影响。
本研究评估了基于“足够好的性”（GES）模型的性咨询对 FSIAD 女性性健康变量的影响。
2021 年，在伊朗对 80 名 FSIAD 女性进行了一项随机临床试验，采用 1:1 分配比例。符合条件的参与者被随机分配到 A 组（女性）和 B 组（夫妇）。女性参加了 4 次基于 GES 模型的每周在线团体性咨询会议，每次持续 120 分钟。在 B 组中，丈夫参加了第 2 次和第 3 次会议。
在咨询前和咨询后 3 个月，评估了女性性健康参数，包括性欲、性满意度、性功能、性困扰、性沟通、性交频率和性功能障碍信念。由于 Bonferroni 校正，考虑到 P<0.007，认为差异具有统计学意义。
干预后，两组的所有性参数均有显著改善（P<0.001），除性功能障碍信念外。在随访期间，B 组的所有性变量的平均评分略高于 A 组。仅在性交频率方面，组间差异具有统计学意义（P<0.01）。
本研究再次证实了 GES 模型作为生物心理社会治疗在管理女性性问题中的作用。考虑到男性不愿意陪妻子去性诊所，仅对女性进行咨询可以在解决性问题方面发挥重要作用，特别是在 FSIAD 的情况下。在线性咨询可节省成本和时间，为讨论敏感话题提供安全空间，并有助于协调团体计划。它确保了咨询的普及性，从而解决了性别不兼容的问题。它是一种强大、互动和可接受的替代面对面访问的方式，为寻求性健康支持的客户提供了便利和保密性。
以下是本研究的一些局限性：对 FSIAD 女性进行了随机对照试验，应用了适当的模型和量表，包括配偶，并评估了在线团体性咨询。然而，本研究的结果可能不适用于没有伴侣的女性。
