Structured PLISSIT Counseling Improves Sexual Function in Middle-Aged Women, Trial Finds

A randomized controlled trial conducted in Tehran found that a structured counseling program based on the PLISSIT model significantly improved both sexual function and sexual quality of life among middle-aged women, with benefits still evident six months after the intervention ended. The study, published in BMC Women’s Health, randomized 113 eligible women attending selected comprehensive health centers to either the counseling program or a control group.

In this trial, participants in the intervention arm received six individual counseling sessions delivered over four weeks. Researchers assessed outcomes using the Female Sexual Function Index (FSFI) and the Sexual Quality of Life–Female (SQOL-F) questionnaire at baseline, at four weeks, and at six months after the intervention. Thirteen participants were lost during follow-up, leaving 100 women—50 in each group—in the complete-case analysis.

The results were consistent across measures. Linear mixed-effects models showed significant group-by-time interactions for the total FSFI score, all six FSFI domains, and the SQOL-F score, all with P values below 0.001. Compared with the control group, women who received the counseling had higher total FSFI scores at four weeks, with a mean difference of 8.62 points (95% confidence interval 7.00 to 10.24), and at six months, with a mean difference of 9.12 points (95% CI 7.50 to 10.74). Sexual quality of life scores showed even larger gaps: the SQOL-F mean difference was 35.24 points (95% CI 29.98 to 40.50) at four weeks and 37.00 points (95% CI 31.74 to 42.26) at six months.

The trial was registered with the Iranian Registry of Clinical Trials in December 2018. The authors conclude that PLISSIT-based counseling improved sexual function and sexual quality of life among middle-aged women with sexual dysfunction, and suggest that this structured counseling approach may be a useful option for addressing sexual health concerns in routine midlife healthcare.

Subject of Research: A randomized controlled trial of PLISSIT-based counseling for sexual function and sexual quality of life in middle-aged women in Tehran, Iran.

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

Article References: Keshavarz, Z., Shariatifar, N., Riazi, H., Golezar, S., & Nasiri, M. (2026). Effect of PLISSIT-based counseling on sexual function and sexual quality of life among middle-aged women: a randomized controlled trial. BMC Women's Health. https://doi.org/10.1186/s12905-026-05057-y

Image Credits: AI Generated

DOI: 10.1186/s12905-026-05057-y

Keywords: PLISSIT model, sexual function, sexual quality of life, middle-aged women, randomized controlled trial, FSFI, SQOL-F, counseling, women's health, Iran, Effect, PLISSIT-based