Posted 12.30.2019 | by AMRA

Women diagnosed with epilepsy often report diminished sexual interest and arousal. This is due to a variety of factors including the side-effects of anti-epileptic medication and fear of triggering seizures during sexual activity. Mindfulness-based interventions have previously been shown to improve sexual functioning in women with difficulties in sexual interest and arousal, women with gynecological cancer, and men with erectile dysfunction.

Lin et al. [Seizure] conducted a randomized controlled study to assess the efficacy of Mindfulness-Based Cognitive Therapy for Sexuality (MBCT-S) in improving sexual functioning and quality of life in women with epilepsy and their partners.

The researchers randomly assigned 660 women aged 65 or older with epilepsy (average age = 71 years) drawn from 15 Iranian neurology clinics to one of three experimental conditions: 1) MBCT-S for women and their sexual partners, 2) MBCT-S for women and their sexual partners plus a 3-session sexual counseling training program provided to their neurology health care provider, and 3) treatment-as-usual for epilepsy.

MBCT-S was offered in an 8-week small-group format delivered in 90-minute weekly sessions. The intervention was similar to standard MBCT, but included psychoeducation about sexual desire, arousal, and intimate relationships, cognitive therapy regarding sexual beliefs, and sensate focus.

The women and their partners were assessed at baseline, 1-month post-intervention, and 6-months post-intervention. The primary outcome measure was the women’s self-report of desire, arousal, lubrication, orgasm, satisfaction, and pain.

Secondary measures included self-report measures of emotional and sexual intimacy, sexual distress, mindfulness during sex (using the Five-Facet Mindfulness Scale adapted for sexual behaviors), quality of life, and others.

Both MBCT-S groups showed significant improvement in sexual mindfulness, women’s sexual functioning and sexual distress, women’s and partners’ emotional and sexual intimacy, and partners’ erectile function compared to controls, both at 1-and 6-months post-intervention.

Both MBCT-S groups also showed significantly greater improvements in anxiety and depression than controls at 1 and 6 months, and improved quality of life at 6 months. Only the MBCT-S group that included health care providers showed significantly larger improvements in sexual attitudes and beliefs and quality of the patient-doctor relationship than controls.

The MBCT-S group that included health care providers improved significantly more at 1-month post-intervention than both comparison groups on women and partner ratings of sexual mindfulness, sexual intimacy, and partner ratings of emotional intimacy. This superiority over both comparison groups persisted at 6-months, with the addition of a significant difference in improved women’s sexual functioning.

Improvements in sexual functioning and distress were significantly mediated by improvements in mindfulness during sex and in sexual and emotional intimacy.

This study shows that MBCT-S improves sexual functioning and sexual and emotional intimacy in older Iranian women with epilepsy and their partners, that these improvements persist over time, and that these improvements are mediated by increased mindfulness during sex. It also shows a potential added benefit of educating epilepsy health care providers about sexual counseling. The study is limited by its reliance on a treatment-as-usual control.

Reference:

Lin, C. -Y., Potenza, M. N., Broström, A., Blycker, G. R., & Pakpour, A. H. (2019). Mindfulness-Based cognitive therapy for sexuality (MBCT-S) improves sexual functioning and intimacy among older women with epilepsy: A multicenter randomized controlled trial. Seizure.

[Link to study]