Effects of Mindfulness-Based Therapies for Female Sexual Dysfunction: A Meta-Analytic Review

Abstract

Mindfulness-based therapy (MBT) represents a potentially efficacious treatment for female sexual dysfunction (FSD). A number of recent trials assessing MBT for FSD have been published, but we are aware of no existing meta-analysis synthesizing these results. We conducted a literature review to identify all published trials of MBT for FSD. References of retrieved studies were searched and key authors were contacted with requests for complete but unpublished trials. Eleven trials, including a total of 449 participants, were identified. Two of these studies were under review at the time of the current analyses. Four trials utilized wait-list controls. All aspects of sexual function and subjective sexual well-being exhibited significant improvement during MBT, with effect sizes generally moderate. Controlled effect sizes versus wait list were of similar magnitude in most cases; however, they did not reach statistical significance for multiple outcome measures. Results for some outcomes were consistent with possible publication bias. For some outcomes, larger effect sizes tended to be reported in studies requiring participants to be in a romantic relationship or studies providing individual (versus group) therapy. MBT may be an efficacious intervention for FSD. However, important limitations of the current literature and future directions for research are discussed.

Acknowledgments

The authors would like to thank Dr. Lori Brotto for providing data from unpublished studies, as well as Dr. James Friedrich for aid in data analysis and review of manuscript drafts.

Supplemental data for this article can be accessed at www.tandfonline.com/HJSR.

Notes

¹ Dr. Brotto was also contacted regarding any completed but unpublished trials.

² This approach yields effect size measures more directly comparable to between-groups measures than is the case when dividing mean differences by the SD of difference scores that contributes to the paired t value. It generally results in a more conservative numerical estimate of effect size (Morris & DeShon, 2002), primarily under common circumstances in which pre-post measure correlations exceed .5. When the correlation between pre- and posttreatment data was missing, we utilized a conservative estimate of .5. This value has been used by recent meta-analyses of CBT for sexual dysfunction (Frühauf et al., 2013) and is in line with the lowest median correlations across data made available by Dr. Brotto (the median correlations across studies ranged from a low of r = .53 for sexual desire and sexual satisfaction to a high of r = .72 for lubrication).

³ One additional study (Brotto et al., 2012) included a small control group receiving CBT for sexual dysfunction. Given that only one study has reported results using an active therapy control, we focused instead on studies using a wait-list control condition.