Sexual counseling based on the BETTER model in postmenopausal women: a randomized controlled trial

Climacteric. 2025 Oct;28(5):561-568. doi: 10.1080/13697137.2025.2486049. Epub 2025 Apr 22.

Abstract

Objective: Sexual dysfunction and sexual dysfunctional beliefs are common problems in postmenopausal women. The purpose of this study was to evaluate the effect of sexual counseling based on the BETTER (Bring up, Explain, Tell, Time, Educate, Record) model in these women.

Methods: The randomized controlled trial study was conducted with 106 postmenopausal women in 2023. Eligible women were assigned randomly to the intervention and control groups. Accordingly, the intervention group received two individual counseling sessions based on the BETTER model. The Female Sexual Function Index (FSFI) and the Sexual Dysfunctional Beliefs Questionnaire (SDBQ) were used for collecting data at baseline and 4 weeks after the intervention.

Results: The sexual function score in the intervention group increased from 15.97 to 18.51 (p = 0.001), and the score of sexual dysfunctional beliefs decreased from 33.80 to 24.86 (p = 0.001). In the control group, the sexual function score decreased from 19.09 to 18.59 (p = 0.032) and the sexual dysfunctional beliefs score increased from 31.83 to 32.18 (p = 0.111).

Conclusion: Sexual counseling based on the BETTER model has demonstrated efficacy in promoting sexual function and diminishing sexual dysfunctional beliefs. Consequently, the use of this model in the sexual health counseling of postmenopausal women can be considered.

Trial registration: IRCT20150128020854N12; October 12, 2023. Iranian Registry of Clinical Trials: https://irct.behdasht.gov.ir/user/trial/71128/view.

Keywords: BETTER model; menopause; sexual dysfunctional beliefs; sexual function; sexual health.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Counseling* / methods
  • Female
  • Humans
  • Iran
  • Middle Aged
  • Postmenopause* / psychology
  • Sex Counseling* / methods
  • Sexual Dysfunction, Physiological* / psychology
  • Sexual Dysfunction, Physiological* / therapy
  • Sexual Dysfunctions, Psychological* / psychology
  • Sexual Dysfunctions, Psychological* / therapy
  • Surveys and Questionnaires