How Does Paying Attention Improve Sexual Functioning in Women? A Review of Mechanisms.
Nikita Arora, Lori A Brotto
Sexual medicine reviews July 2017 DOI: 10.1016/j.sxmr.2017.01.005 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized Peer reviewed |
|---|---|
| Population | Women with female sexual dysfunction (FSD) and general populations, as reported in the reviewed studies |
| Intervention | Mindfulness-based interventions |
| Topics | Meditation |
| Keywords | Body image Interoception Sexual dysfunction |
| Key findings | In four studies of women with FSD, significant mediators of mindfulness-related improvement included relationship satisfaction, genital self-image, interoceptive awareness, depressed mood, anxiety, and trait mindfulness, with interoceptive awareness having the most supporting evidence. The authors argue that clinicians can use interoceptive awareness, depression, and trait mindfulness to identify patients likely to benefit from mindfulness-based treatment, and that randomized controlled trials should test these and other mediators. |
Abstract
Female sexual dysfunction (FSD), consisting of a constellation of distressing sexual symptoms, is highly prevalent worldwide. Given the central role played by psychological factors in the development of FSD, psychologically and in particular mindfulness-based interventions have arisen as potential treatment options for women. Although mindfulness-based interventions have been evaluated in samples of women with gynecologic cancer; a history of sexual abuse; multiple sclerosis; and spinal cord injury; and provoked vestibulodynia, the mechanisms by which mindfulness leads to improvements in sexual functioning are largely unstudied. To summarize the literature on mechanisms of mindfulness interventions in general and to hypothesize which mechanisms most likely apply to samples of women with FSD. Medline was searched with terms such as mindfulness, meditation, mediator, mode, moderator, mechanism, sex, and sexual dysfunction. Only studies that conducted a formal mediation or moderation analysis were included. We also conducted a broader review on mechanisms in other populations, with slightly modified inclusion criteria: the terms sex and sexual dysfunction were removed and only studies from 2012 to 2016 and studies that included an active mindfulness intervention were included. In general populations, trait mindfulness and decentering were the most common mechanisms identified for the efficacy of mindfulness. In four studies that examined mediators of improvement in samples with FSD, the following mediators were found to be significant: relationship satisfaction, genital self-image, interoceptive awareness, depressed mood, anxiety, and trait mindfulness, of which interoceptive awareness had the most supporting evidence. Clinicians and researchers can use the identified mediators of improvement (ie, interoceptive awareness, depression, and trait mindfulness) when making decisions about which patient might be more likely to benefit from a mindfulness-based approach to treating sexual dysfunction. Future work should examine these mediators and other putative mediators and moderators in randomized controlled trials of mindfulness. Arora N, Brotto LA. How Does Paying Attention Improve Sexual Functioning in Women? A Review of Mechanisms. Sex Med Rev 2017;5:266-274.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cited by 3
- A virtual, group-based mindfulness intervention for midlife and older women with low libido lowers sexual distress in a randomized controlled pilot study The Journal of Sexual Medicine June 23, 2023
- The Effect of Mindfulness-Based Cognitive Therapies on Sexual Function, Sexual Distress, and Depression in Women: A Meta-Analysis Study. International journal of sexual health : official journal of the World Association for Sexual Health 2025
- Mindfulness and Sex Education for Sexual Interest/Arousal Disorder: Mediators and Moderators of Treatment Outcome. The Journal of Sex Research May 2023
Cites 16
- How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective Perspectives on Psychological Science October 14, 2011
- Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis The Journal of Alternative and Complementary Medicine May 1, 2009
- Effects of Mindfulness Training on Body Awareness to Sexual Stimuli Psychosomatic Medicine November 1, 2011
- A Pilot Study of Eight-Session Mindfulness-Based Cognitive Therapy Adapted for Women's Sexual Interest/Arousal Disorder. The Journal of Sex Research September 2017
- Mindfulness-Based Cognitive Therapy (MBCT) Reduces the Association Between Depressive Symptoms and Suicidal Cognitions in Patients With a History of Suicidal Depression Journal of Consulting and Clinical Psychology August 24, 2015
and 11 more in the library