Sexual health issues are common, yet individuals often hesitate to seek help. In certain populations, especially those with medical conditions, sexual dysfunction is prevalent. Mental well-being is linked to sexual health, with depression and anxiety both impacting and being impacted by sexual issues.

Interventions, including acceptance- and mindfulness-based psychotherapy like acceptance and commitment therapy (ACT) as well as mindfulness-based cognitive therapy (MBCT), are promising approaches for addressing sexual dysfunction and related psychological effects. These methods focus on accepting distress, committing to goals, and cultivating nonjudgmental present-moment awareness to enhance sexual health in men, women, and couples.

Mindfulness and ACT for Men

Erectile dysfunction (ED) negatively affects a person’s sexual health and can induce anxiety and even avoidance of sexual contact. ACT and mindfulness interventions are emerging as effective approaches for men facing ED. When it comes to ED, ACT involves setting goals, participating in directed exercises, and accepting one’s discomfort, while mindfulness emphasizes general present-moment awareness.

In prostate cancer survivors with ED, ACT-based interventions have shown promise in overcoming avoidance (of one’s sexual health goals) and improving adherence to erectile rehabilitation programs. These interventions also show promise in increasing satisfaction with ED treatments and sexual self-esteem, and reducing sexual bother and prostate cancer treatment regret.

Mindfulness programs for situational ED demonstrate positive effects on erectile functioning, sexual satisfaction, and self-awareness of contributing factors to ED. Participants express that mindfulness allows them to normalize their experience with ED and increase their awareness during sexual activity. As such, mindfulness is a valuable tool for addressing ED-related anxiety.

Mindfulness and ACT for Women

In the realm of interventions for women’s sexual health, mindfulness and ACT may play significant roles. Limited research exists on ACT for female sexual dysfunction, but studies indicate its effectiveness in promoting better sexual self-efficacy and quality of life in reproductive-age and postmenopausal women.

Online mindfulness interventions have shown promise in reducing distress and improving sexual function for women with sexual interest/arousal disorder and survivors of gynecological cancer. Larger randomized controlled trials (RCTs) support the efficacy of MBCT in enhancing sexual health outcomes, emphasizing its importance in addressing sexual distress and relationship satisfaction.

Mindfulness and ACT for Couples

In couples’ therapy, both ACT and mindfulness, particularly in the form of MBCT, target psychoeducation and avoidance of goals. ACT for couples emphasizes value alignment, acceptance of difficulties, behavioral activation, and emotional control, fostering compatibility and communication. A study in Iran showed that ACT significantly increased sexual satisfaction in couples.

Mindfulness interventions for couples, such as those following prostate cancer treatments, focus on accepting and enjoying what is sexually possible, with studies indicating improvements in sexual satisfaction and distress. Larger RCTs support the efficacy of both mindfulness and cognitive behavioral therapy in enhancing sexual and relationship outcomes for couples.

Conclusion

Sexual health and psychological well-being are interconnected, with distress in one area influencing the other. Both ACT and mindfulness interventions play crucial roles in improving sexual health and well-being for individuals and couples. ACT focuses on reducing avoidance and promoting activation of activities, while mindfulness aims to reduce anxiety and distractibility during sexual experiences.

References:

• Flaherty, K. R., Demirjian, C. C., & Nelson, C. J. (2024). The role of acceptance and mindfulness-based therapies in sexual health. The Journal of Sexual Medicine, 21(1), 4–8. https://doi.org/10.1093/jsxmed/qdad142 Top of Form