Effect of PLISSIT-based counseling on sexual function and sexual quality of life among middle-aged women: a randomized controlled trial

Abstract Background Sexual dysfunction is common among middle-aged women and may negatively affect their sexual quality of life (QoL). This study aimed to evaluate the effectiveness of PLISSIT-based counseling on sexual function and sexual QoL among middle-aged women. Methods This randomized controlled trial was conducted among middle-aged women attending selected comprehensive health centers in Tehran, Iran. A total of 113 eligible women were randomized to either a PLISSIT-based counseling group ( n = 58) or a control group ( n = 55). During follow-up, 13 participants were lost, and 100 participants (50 in each group) completed the study and were included in the complete-case analysis. The intervention consisted of six individual PLISSIT-based counseling sessions delivered over 4 weeks. Sexual function and sexual QoL were assessed using the Female Sexual Function Index (FSFI) and the Sexual QoL–Female (SQOL-F) questionnaire at baseline, 4 weeks, and 6 months after the intervention. Results Linear mixed-effects models showed significant group-by-time interactions for the total FSFI score, all six FSFI domains, and SQOL-F (all P < 0.001). Compared with the control group, the intervention group had higher total FSFI scores at 4 weeks (mean difference [MD] 8.62, 95% CI 7.00–10.24) and 6 months (MD 9.12, 95% CI 7.50–10.74). Similarly, SQOL-F scores were higher at 4 weeks (MD 35.24, 95% CI 29.98–40.50) and 6 months (MD 37.00, 95% CI 31.74–42.26). Improvements remained evident at the 6-month follow-up. Conclusions PLISSIT-based counseling improved sexual function and sexual QoL among middle-aged women with sexual dysfunction. This structured counseling approach may be a useful option for addressing sexual health concerns in routine midlife healthcare. Trial registration Iranian Registry of Clinical Trials (IRCT20181205041853N1), registered on 17 December 2018. Available at: https://www.irct.ir/trial/35698