The October 2019 issue of The Journal of Sexual Medicine has an article reviewing the efficacy of mindfulness meditation-based interventions for sexual dysfunction. As mindfulness-based therapies (MBT) are increasingly popular in the treating sexual issues, the authors set out to “assess evidence-based data on the clinical efficacy of these interventions.”
Studies indicate that MBT led to improvement in subjectively evaluated arousal and desire, sexual satisfaction, and a reduction of fear linked with sexual activity, as well as improving the consistency between the subjectively perceived arousal and genital response in women. The research indicated that MBT did not make a significant change in a reduction of pain during sexual activities. Evidence-based data were found on the efficacy of MBT in the treatment of male erectile dysfunction in 1 study.
This meta-analysis reviewed 15 original research articles evaluating MBT used to reduce symptoms of sexual dysfunction. Of the 15 articles, 4 explored genital-pelvic pain, 10 desire and/or arousal in women, and 1 erectile dysfunction in men. Each of the 15 studies were summarized and reviewed in the article.
As stated in the above quote, they found a decrease in symptoms for some facets of sexual dysfunction, especially in the arousal and desire realm as well as symptoms related to anxiety and “negative cognitive schemas”.
The authors did point out a few issues that became apparent in their review:
- The available research was only on group sex therapy based interventions. Individual therapy approaches are lacking empirical data though it is likely this is the most common style of intervention. It is conceivable that the bulk of the treatment change may be due to the group format, not the mindfulness techniques. It would take more research to show mindfulness based techniques have empirical support in individual/dyadic therapy.
- Despite 4 studies assessing it, “the domain where the improvement was the rarest is pain during intercourse” (p. 1593). They did see an overall reduction in pain and sexual anxiety as well as improvement in self esteem, and various other markers (depending upon the particular study).
- Only one of the studies addressed male dysfunction. The authors pointed out difficulty getting men to do group work preferring individual therapy. It is possible, however, that MBT could be valuable in “treating sexual dysfunction in men who, as a result of stress, tension, or anxiety, experience erectile disorders, premature ejaculation, or reduced desire” (p. 1593).
- Research on other sexual dysfunctions (i.e., vaginismus, orgasm/ejaculatory disorders) is absent in the literature.
- MBT was “usually linked with cognitive-behavioral and relaxation techniques and with psychoeducation” (p. 1591). While these are good adjuncts, they make it difficult to state the results are due to the MBT.
- The design of the studies was often weak in other areas (i.e., small sample sizes, assessment issues, lack of control group).
Despite these problems with the research available, the authors pointed out:
Data presented in the literature allow us to draw a conclusion that the prepared models of mindfulness intervention constitute a valuable tool in the therapy of various types of sexual dysfunctions, especially if they are related to anxiety.
So What? …
MBT continues to show promise as evidenced by these studies, especially when embeded in a group therapy format. Clinicians should be careful in representing it well to clients however. While out theories and perhaps clinical experience suggest it is effective, this meta review at least, shows a lack of evidence for it’s use in individual or conjoint therapy.
Articles like these highlight the need for counselors (LPC, MHCC, NCC, etc.), therapists (MFT, CST), psychologists, and social workers to obtain quality continuing education. If people helpers don’t stay current, we perpetuate social myths rather than provide grounded help. Stay connected with Sexualis Veritas to learn about upcoming CE opportunities grounded in research.
What do you think? What do you think has the most impact – MBT, the group format, CBT techniques, psychoeducation, …?