Despite their widespread prevalence, there are no existing evidence-based psychological treatments for women with sexual desire and arousal disorder. Mindfulness, the practice of relaxed wakefulness, is an ancient eastern practice with roots in Buddhist meditation which has been found to be an effective component of psychological treatments for numerous psychiatric and medical illnesses. In recent years, mindfulness has been incorporated into sex therapy and has been found effective for genital arousal disorder among women with acquired sexual complaints secondary to gynecologic cancer. The aim of this study was to adapt an existing mindfulness-based psychoeducation (PED) to a group format for women with sexual desire/interest disorder and/or sexual arousal disorders unrelated to cancer. Twenty-six women participated in three 90-minute sessions, spaced 2 weeks apart, with four to six other women. Group PED was administered by one mental health trained provider and one gynecologist with post graduate training and experience in sexual medicine. Prior to and following the group, women viewed audiovisual erotic stimuli and had both physiological (vaginal pulse amplitude) and subjective sexual arousal assessed. Additionally, they completed self-report questionnaires of sexual response, sexual distress, mood, and relationship satisfaction. There was a significant beneficial effect of the group PED on sexual desire and sexual distress. Also, we found a positive effect on self-assessed genital wetness despite little or no change in actual physiological arousal, and a marginally significant improvement in subjective and self-reported physical arousal during an erotic stimulus. A follow-up comparison of women with and without a sexual abuse history revealed that women with a sexual abuse history improved significantly more than those without such history on mental sexual excitement, genital tingling/throbbing, arousal, overall sexual function, sexual distress, and on negative affect while viewing the erotic film. Moreover, there was a trend for greater improvement on depression scores among those with a sexual abuse history. These data provide preliminary support for a brief, three-session group psychoeducational intervention for women with sexual desire and arousal complaints. Specifically, women with a history of sexual abuse improved more than women without such a history. Participant feedback indicated that mindfulness was the most effective component of the treatment, in line with prior findings. However, future compartmentalization trials are necessary in order to conclude this more definitively.
