Cognitive-behavioral group therapy for women with hypoactive sexual desire: A pilot randomized study

Lerner, Theo; Bagnoli, Vicente Renato; Pereyra, Elsa Aida Gay de; Fonteles, Lucivanda Pontes; Sorpreso, Isabel Cristina Esposito; Soares Júnior, José Maria; Baracat, Edmund Chada

doi:10.1016/j.clinsp.2022.100054

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Original articles • Clinics 77 • 2022 • https://doi.org/10.1016/j.clinsp.2022.100054 copy

Cognitive-behavioral group therapy for women with hypoactive sexual desire: A pilot randomized study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background:

Hypoactive Sexual Desire Disorder (HSDD) is a very prevalent sexual problem, with limited options for treatment. Given that psychological factors are major contributors to the disorder, a therapy such as Cognitive-Behavioral Therapy (CBT) may be useful to treat HSDD.

Objective:

To evaluate the effects of group CBT on women with HSDD.

Method:

Clinical trial randomized study with 106 women diagnosed with HSDD, who were divided as follows: Group 1 (n = 53) underwent group CBT for 8-weeks, and Group 2 (n = 53), were put on a waiting list and used as a control group. Sexual function was assessed by the Female Sexual Quotient (FSQQ) at the initial interview and after 6-months. Mann Whitney test was used for group comparison. Main Outcome Measures: demographics, education, sexual history, FSQQ and its domains for sexual function assessment.

Results:

Both groups had similar characteristics regarding sexual response, self-image, and relationship with a partner at the initial interview. Women undergoing therapy showed significant improvement in sexual function when compared with the control group. The overall FSQQ result showed an average growth of 18.08 points (95% CI 12.87‒23.28) for the therapy group against a decrease of 0.83 points (95% CI 3.43‒1.77) for controls (p < 0.001). The five domains of the questionnaire also exhibited significant improvement in the therapy group: desire and interest (p = 0.003), foreplay (p = 0.003), excitation and tuning (p < 0.001), comfort (p < 0.001), and orgasm and satisfaction (p < 0.001).

Conclusion:

Group CBT was shown to be an effective tool for treating HSDD.

Keywords:
Group Therapy; Cognitive-behavioral Therapy; Female sexual dysfunction; Hypoactive sexual desire disorder

Highlights

Group cognitive-behavioral therapy (CBT) have a positive influence on women’s sexuality.
Group CBT was shown to be an effective tool for treating Hypoactive Sexual desire disorder in women.
Group CBT can be a short-term focal intervention carried out by gynecologists specialized in sexual health.
Group CBT can be used in a high-complexity care setting.

	Intervention	Control	p
Age	40.6 ± 6.36	38.5 ± 10.36	0.312
Race, n (%)
White	26 (49%)	19 (35.8%)
Nonwhite	27 (51%)	34 (63.2%)
Religion, n (%)
Catholic	34 (64.1%)	29 (54.7%)
Evangelic	14 (26.4%)	16 (30.2%)
Other	5 (9.5%)	8 (15.1%)
Education, n (%)
Elementary	29 (54.7%)	32 (60.3%)
High school	21 (39.6%)	18 (34.0%)
College	3 (5.7%)	3 (5.7%)
Marital Status, n (%)
Married	38 (71.7%)	42 (79.2%)
Single	6 (11.3%)	5 (11.3%)
Divorced	5 (9.5%)	6 (9.5%)
Widow	4 (7.5%)	-
Relationship lenght (years)	13.63 ± 10.88	12.43 ± 9.31	0.514
Parity	1.96 (±1.49)	2 (±2.17)	0.339

Domain	Intervention		Controls			Variation in FSQQ scores			p
Domain	Baseline	Final	P (bxf)	Baseline	Final	P (bxf)	Controls	Intervention	p
Desire and interest^a a Comparing baseline FSQQ intervention group scores with controls (p < 0.02) - Desire & Interest, Foreplay, and the total FSQQ score. ,^c c Comparing final FSQQ intervention group scores with controls (p < 0.00001) ‒ Desire & Interest, Foreplay, Excitement & Attunement, Orgasm & Satisfaction, and the total FSQQ score.	15.64 ± 7.55	19.83 ± 6.78	0.005	11.79 ± 6.27	11.38 ± .86	NS	-0.42 ± 4.37	4.19 ± 8.18	0.043
Foreplay^a a Comparing baseline FSQQ intervention group scores with controls (p < 0.02) - Desire & Interest, Foreplay, and the total FSQQ score. ,^c c Comparing final FSQQ intervention group scores with controls (p < 0.00001) ‒ Desire & Interest, Foreplay, Excitement & Attunement, Orgasm & Satisfaction, and the total FSQQ score.	7.13 ± 3.75	8.62 ± 2.96	0.055	5.25 ± 3.56	4.87 ± 3.05	NS	-0.38 (±2.19)	1.49 ± 3.94	0.004
Excitement and attunement^b b Comparing baseline FSQQ intervention group scores with controls (NS) ‒ Excitement & Attunement, Comfort, Orgasm & Satisfaction. ,^c c Comparing final FSQQ intervention group scores with controls (p < 0.00001) ‒ Desire & Interest, Foreplay, Excitement & Attunement, Orgasm & Satisfaction, and the total FSQQ score.	10.51±5.64	14.70 ± 5.47	0.0003	9.64 ± 6.26	9.64 ± 5.79	NS	0.00 (±2.61)	4.19 ± 5.96	<0.001
Comfort^b b Comparing baseline FSQQ intervention group scores with controls (NS) ‒ Excitement & Attunement, Comfort, Orgasm & Satisfaction. ,^d d Comparing final FSQQ intervention group scores with controls (p < 0.01) – Comfort.	11.83 ± 6.28	14.40 ± 5.05	0.02	11.79 ± 6.50	10.98 ± 6.56	NS	-0.81 (±2.99)	2.57 ± 5.73	<0.001
Orgasm and satisfaction^b b Comparing baseline FSQQ intervention group scores with controls (NS) ‒ Excitement & Attunement, Comfort, Orgasm & Satisfaction. ,^c c Comparing final FSQQ intervention group scores with controls (p < 0.00001) ‒ Desire & Interest, Foreplay, Excitement & Attunement, Orgasm & Satisfaction, and the total FSQQ score.	7.05 ± 4.79	12.77 ± 5.91	<0.00001	5.62 ± 4.74	5.77 ± 4.90	NS	0.15 (±3.03)	5.72 ± 5.87	<0.001
FSQQ Total^a a Comparing baseline FSQQ intervention group scores with controls (p < 0.02) - Desire & Interest, Foreplay, and the total FSQQ score. ,^c c Comparing final FSQQ intervention group scores with controls (p < 0.00001) ‒ Desire & Interest, Foreplay, Excitement & Attunement, Orgasm & Satisfaction, and the total FSQQ score.	50.49 ± 19.04	68.57 ± 19.20	<0.001	42.34 ± 19.10	41.51 ± 17.54	NS	-1.45 (±9.49)	18.15 ± 19.52	<0.001

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[1] *Corresponding author. E-mail address:theolerner.med@gmail.com (T. Lerner).