Psychological treatments for sexual concerns in perimenopausal and postmenopausal women: a systematic review and meta-analysis
Notice bibliographique
Résumé
IMPORTANCE: Sexual concerns are commonly reported by perimenopausal and postmenopausal women. Nonpharmacological treatments, including psychological-based treatments, may serve as an alternative and/or complementary option for those who cannot, or choose not, to take medication or who continue to experience symptoms despite their use. OBJECTIVE: This systematic review and meta-analysis examined psychological interventions that directly targeted and/or assessed sexual functioning in perimenopausal and postmenopausal women using standardized measures. EVIDENCE REVIEW: Web of Science, MEDLINE, and PubMed were searched for studies that evaluated the effects of psychological interventions for sexual concerns during perimenopause and postmenopause. Risk of bias assessments were done using the Cochrane Risk-of-Bias Tool and the Newcastle-Ottawa Scale. Data were pooled in a primary meta-analysis using the Female Sexual Function Index (FSFI), as well as subgroup analyses based on psychological intervention type, with effects reported separately for each subgroup. FINDINGS: Sixteen articles (n=1,445) met the eligibility criteria and were included in the systematic review and meta-analysis. Overall, nine randomized controlled trials (n=738) containing FSFI data were pooled in a meta-analysis showing psychological interventions were associated with significant improvements in sexual concerns (standardized mean difference [SMD]=1.37, 95% CI=1.17-1.58, P <0.00001; n=475). Subgroup analysis based on type of psychological intervention revealed that cognitive-behavioral therapy (SMD =-0.00, 95% CI=-0.26 to 0.25; n=233; I2 =0%) and mindfulness-based interventions (SMD =0.02, 95% CI=-0.40 to 0.45; n=86; I2 =0%) had no to small effect on the sexual function in perimenopausal and postmenopausal women, while education programs (SMD=2.53, 95% CI=-2.19 to 2.86; P <0.00001; n=268; I2 =94%) and counseling (SMD=2.43, 95% CI=1.92-2.94; P <0.00001; n=106; I2 =0%) had a large effect. Only one motivational interviewing study (effect size of 0.72) was included, but it revealed a large effect on sexual functioning. Overall risk of bias ranged from low to some concerns, with one study scoring high. CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis suggests that psychological interventions are an effective nonpharmacological treatment option for addressing sexual concerns in perimenopausal and postmenopausal women. Although cognitive-behavioral therapy and mindfulness-based approaches showed small to no effects on sexual concerns, these findings should be interpreted with caution, as the included studies did not directly target sexual concerns but instead assessed them as secondary outcomes. Psychological interventions should be considered when discussing treatment options for sexual concerns in perimenopausal and postmenopausal women.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,000 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».