Prognosis
Response to treatment
There are limited data on the long-term effects of psychological treatments for women's sexual dysfunction. Meta-analysis of controlled clinical trials, mostly involving small-group therapy, noted clear evidence of benefit in symptom severity and sexual satisfaction for women with orgasmic dysfunction and those with low desire.[131][132] Recent mindfulness-based cognitive therapy trials were not included. Quality of method, outcome measures, and reporting was highly variable. Therapy included cognitive behavioural therapy (7 trials), sex therapy (3 trials), or both (7 trials).
Meta-analytic review concluded benefit from mindfulness-based cognitive therapy as compared to waitlist.[143] For women with sexual dysfunction post breast cancer, a systematic review suggested the most effective interventions are couple-based psycho-educational interventions that include an element of sexual therapy.[66]
Among pharmacological studies, there is a marked placebo response indicating that having a positive attitude, and anticipating pleasure and arousal, are key ingredients for improvement in function. The long-term benefit from placebo response is unknown. In a study that explored correlates of placebo response in women with sexual dysfunction seeking treatment, age of woman and length of relationship were positive predictors of a placebo response.[173] The important components of placebo, including the physician’s empathy and validation of distress, are in need of further study.[174]
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