Cognitive behavior therapy for female sexual dysfunction: a systematic review and meta-analysis.

Abstract

Introduction: Sexual dysfunction has a negative influence on both human physical and psychological health across various ages and frequently results in the deterioration of quality of life for individuals and/or partners.

Objective: The objective of the study was to assess the effectiveness of cognitive behavioral therapy (CBT) for female sexual dysfunction (FSD).

Methods: We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and Web of Science databases from inception to January 6, 2023 (updated on April 15, 2024). The risk of bias in all included randomized controlled trials (RCTs) was assessed using the Cochrane risk of bias tool (revised version 2.0), and meta-analysis was conducted using R (version 4.2.0). We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to evaluate the certainty of the evidence.

Results: Ten RCTs involving 837 patients were included, and three RCTs were judged at high risk of bias due to missing outcome data and baseline imbalances. In the post-intervention follow-up, CBT participants showed a greater increase in FSFI scores than those receiving routine care (MD: 7.63, 95% CI: 5.25 to 10.02, GRADE: low), and greater improvement than waitlist participants (MD: 3.13, 95% CI: 0.90 to 5.35, GRADE: moderate). In the short-term follow-up (4 to 24 weeks after completion of intervention), CBT participants had a greater increase in FSFI scores than routine care (MD: 11.13, 95% CI: 0.27 to 22.00, GRADE: low) and waitlist participants (MD: 3.80, 95% CI: 1.46 to 6.14, GRADE: very low).

Conclusion: CBT can improve the clinical symptoms of patients with FSD. However, large-scale RCTs are needed in the future.