Implementing a midwife-based counseling education program may be an effective approach to improving sexual function among postmenopausal women, according to a study published in Menopause.

Researchers conducted a randomized controlled clinical trial from November 2016 to September 2017 to investigate the effectiveness of a midwife-based counseling education program on sexual function in postmenopausal women (n=52) aged 44 to 55 years. Participants were included in the study if they had a Female Sexual Function Index (FSFI) score of less than 26.5, lived with a spouse, had not menstruated for at least 1 year, demonstrated basic literacy, had sexual dysfunction for the past 4 weeks, did not report issues with drug dependence, and had a general health score greater than 23 on the Goldberg General Health Questionnaire (GHQ-28).

Participants visited the clinic with their spouses and completed a demographic details questionnaire, the FSFI, the GHQ-28, and the International Index of Erectile Function (IIEF) in a face-to-face interview with a researcher. A preliminary interview was then conducted by a counseling midwife who assessed menopause status, psychiatric status, and medical health, and conducted genital and pelvic examinations to assess for sexually transmitted infections. Participants were randomly assigned to the trial group (Group A) and the control group (Group B). Educational sessions were then held individually for each couple and included four 70-minute sessions held at 10-day intervals. The control group received no interventions during this time. A post-test assessment was conducted 2 weeks later; follow-up and reassessment of sexual function occurred 2 months after the first follow-up visit. Both trial and control groups received the same follow-up.

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The intervention program was developed based on a review of literature by the researchers. The demographic details questionnaire assessed the participants’ ages, occupations, education and income levels, medical histories, and other lifestyle factors. The FSFI is a 19-item scale that measures 6 domains of sexual function in women over the preceding 4 weeks, including desire, arousal, and pain. Minimum score was 12 (low sexual function); the maximum score possible was 36 (high sexual function). A score of 0 indicates the absence of sexual function over the past 4 weeks. The 15-item scale of the IIEF measures sexual function in men, with a maximum score of 75; higher scores demonstrate no sexual dysfunction. The GHQ is a 28-item subscale that assesses somatic symptoms, anxiety, social dysfunction, and severe depression.

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A total of 46 participants completed the follow-up stage of the study. Results show no significant differences between the groups before the study with regard to demographic details, the women’s sexual function score, the men’s sexual function score, and the women’s general health. Before the intervention, mean total score on the FSFI was 17.05 in the intervention group and 16.66 in the control group. At the first follow-up, mean FSFI score was 27.18 in the intervention group and 16.06 in the control group. At the second follow-up, the total FSFI score reached 28.20 in the intervention group and 16.32 in the control group, suggesting a significant difference between the intervention and control groups (P <.001). A significant improvement was also observed in all the FSFI domains in the intervention group compared with the control group.

“The results showed the effectiveness of implementing this program in improving the total score and the scores of all the domains of sexual function in the women in the intervention group,” the researchers concluded.


Naeij E, Khani S, Firouzi A, Moosazadeh M, Mohammadzadeh F. The effect of a midwife-based counseling education program on sexual function in postmenopausal women: a randomized controlled clinical trial [published online December 10, 2018]. Menopause. doi: 10.1097/GME.0000000000001270