Association of mindfulness with female sexual dysfunction
Open accessAbstract
Objectives: Female sexual dysfunction (FSD) affects women of all ages. It is often a multifactorial problem with a strong psychosocial component. Mindfulness may help alleviate FSD with nonjudgmental, present-moment awareness and decreased emotional reactivity. The goal of this study was to assess the association between dispositional or trait mindfulness and FSD. Study Design: In this cross-sectional study at a tertiary care women's health clinic, 1718 cisgender women (mean age, 51.9 years) completed the Mindfulness Attention Awareness Scale (MAAS), Female Sexual Function Index (FSFI), and Female Sexual Distress Scale–Revised (FSDS-R). Main Outcome Measures: Regression analysis was used to test the associations of mindfulness, sexual function, and sexual distress with univariate and multivariable analyses, adjusting for potential confounders. Results: Within the sample, 57% of women met FSD criteria (FSFI scores ≤26.55 and FSDS-R ≥ 11). On univariate analysis, higher MAAS scores, signifying greater mindfulness, were associated with higher (better) sexual function scores, lower sexual distress scores, and lower odds of FSD. This association persisted on multivariable analysis after adjusting for potential confounders. Conclusions: Higher trait mindfulness was associated with better sexual function, lower sexual distress, and lower likelihood of FSD. Further studies are needed to assess the role of mindfulness in mitigating FSD. © 2022
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- Findingown data
On univariate analysis, a one-point higher MAAS score was associated with 44% lower odds of sexual distress defined as FSDS-R ≥11 (OR 0.56, 95% CI 0.49-0.63, P<.001).
“A woman scoring 1.0 point higher on the MAAS was 44% less likely to have sexual distress (OR, 0.56 [95% CI, 0.49–0.63]; P<.001).”
Quote in the paperSubstantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Findingown data
MAAS alone had an area under the curve of 0.62 for predicting FSD.
“Although significant, MAAS alone was not the strongest performing model for predicting FSD (AUC=0.62); therefore, we wanted to see if including other characteristics could improve the model performance.”
Quote in the paperSubstantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Findingown data
On multivariable analysis adjusting for age, race, BMI, education, hormone therapy, anxiety/depression symptoms, and relationship satisfaction, higher MAAS was associated with lower odds of FSD (OR 0.77, 95% CI 0.67-0.88, P<.001).
“On multivariable logistic regression analysis, adjusting for patient characteristics including age, race, BMI, education level, use of hormone therapy, anxiety or depression symptoms, and relationship satisfaction, a higher mindfulness score was associated with lower odds of having FSD (OR, 0.77 [95% CI, 0.67–0.88]; P<.001; Table 2).”
- Also stated in: § Results: · plain
“This association persisted on multivariable analysis after adjusting for potential confounders.”
Quote in the paperSubstantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Also stated in: § Results: · plain
- Findingown data
Adding other characteristics to MAAS improved the model performance for predicting FSD, with an area under the curve of 0.68.
“Including these other characteristics with MAAS improved the model performance (AUC=0.68).”
Quote in the paperNot a substantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Findingown data
On univariate analysis, a one-point higher MAAS score was associated with 33% lower odds of sexual problems defined as FSFI ≤26.55 (OR 0.67, 95% CI 0.59-0.75, P<.001).
“A woman scoring 1.0 point higher on MAAS was 33% less likely to have sexual problems (OR, 0.67 [95% CI, 0.59–0.75]; P<.001).”
Quote in the paperSubstantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Findingown data
On secondary multivariable analysis controlling for the same confounders plus FSFI scores, higher mindfulness was associated with lower sexual distress (OR 0.73, 95% CI 0.60-0.88).
“On a secondary multivariable logistic regression analysis, controlling for the same confounding variables as well as FSFI scores, higher mindfulness was associated with lower sexual distress (OR, 0.73 [95% CI, 0.60–0.88]; Supplemental Table).”
Quote in the paperNot a substantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Findingown data
In the study sample, 57% of women met the criteria for female sexual dysfunction based on FSFI ≤26.55 and FSDS-R ≥11.
“Within the sample, 57% of women met FSD criteria (FSFI scores ≤26.55 and FSDS-R ≥ 11).”
- Also stated in: § Results · plain
“About 57% of study participants met the criteria for FSD using the combined end point of FSFI of ≤26.55 and FSDS-R ≥ 11 (Table 1).”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
On univariate analysis, higher scores on the Mindfulness Attention Awareness Scale were associated with higher scores on the Female Sexual Function Index.
“On univariate analysis, higher MAAS scores, signifying greater mindfulness, were associated with higher (better) sexual function scores, lower sexual distress scores, and lower odds of FSD.”
Quote in the paperSubstantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Findingown data
On univariate analysis, higher MAAS scores were associated with lower scores on the Female Sexual Distress Scale-Revised.
“On univariate analysis, higher MAAS scores, signifying greater mindfulness, were associated with higher (better) sexual function scores, lower sexual distress scores, and lower odds of FSD.”
Quote in the paperSubstantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Findingown data
On univariate analysis, a one-point higher MAAS score was associated with 39% lower odds of FSD (OR 0.61, 95% CI 0.55-0.68, P<.001).
“A woman scoring 1.0 point higher on the MAAS was 39% less likely to have FSD (OR, 0.61 [95% CI, 0.55–0.68]; P<.001).”
- Also stated in: § Results: · plain
“On univariate analysis, higher MAAS scores, signifying greater mindfulness, were associated with higher (better) sexual function scores, lower sexual distress scores, and lower odds of FSD.”
Quote in the paperSubstantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Also stated in: § Results: · plain
- Findingown data
All FSFI subdomains except pain showed a significant association with mindfulness.
“All subdomains of FSFI except pain showed a significant association with mindfulness (Table 3).”
Quote in the paperNot a substantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Study design and conductown data
The final analysis included 1718 cisgender women aged 20-85 who completed the FSFI, FSDS-R, and MAAS questionnaires and were sexually active.
“In total, 1718 cisgender women (ages 20–85) who completed the FSFI, FSDS-R, and MAAS questionnaires, and who were sexually active were included in the study.”
Quote in the paperSubstantial claim - Study design and conductown data
Because the study included only sexually active women, it could not comment on FSD correlates of women excluded due to sexual inactivity.
“We included sexually active women in this study, so we were unable to comment on the FSD correlates of women excluded due to sexual inactivity.”
Quote in the paperNot a substantial claim - Study design and conductown data
The study used validated measures of mindfulness (MAAS), sexual problems (FSFI), and sexual distress (FSDS-R).
“We used validated measures of mindfulness (MAAS), sexual problems (FSFI), and sexual distress (FSDS-R) for assessing outcomes, which allows for meaningful comparisons to the existing and future research in this field.”
Quote in the paperSubstantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
- Study design and conductown data
Generalizability is limited because participants were predominantly White, partnered, educated, employed cisgender women seen at a tertiary care center for sexual health and menopause-related concerns.
“Generalizability is also limited, as study participants were predominantly White, partnered, educated, and employed cisgender women seen at a tertiary care center for sexual health and menopause-related concerns.”
Quote in the paperNot a substantial claim
- Classified as probably not a substantial claim. 17
- May combine two claims. 5
Classified as probably not a substantial claim.
PremisecitationAn FSFI score of 26.55 or less indicates significant sexual problems.
“A score of 26.55 or less indicates significant sexual problems [15, 16].”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [15] Rosen, 2000, The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function, J. Sex Marital Ther. source
The table in the Conclusions reports lower mean FSFI full-scale scores for patients with female sexual arousal disorder than for controls, supporting an association between lower scores and sexual problems. Neither that table nor the Discussion establishes 26.55 as a cutoff or says that a score at or below it indicates significant sexual problems (searched: 26.55, cutoff, diagnostic threshold). Page numbers were not available in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measured - cites [16] Wiegel, 2005, The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores, J. Sex Marital Ther. source
Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).
Findingnone givenAmong FSFI domains, sexual satisfaction correlated most strongly with mindfulness.
“Among FSFI domains, sexual satisfaction correlated most strongly with mindfulness.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Cronbach α for the FSFI in the current sample was 0.94.
“The Cronbach α for the current sample was 0.94.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataWith 1718 women, the study had 80% power to detect an odds ratio of 1.15 or more, assuming 60% of women in this tertiary care setting have FSD.
“Assuming 60% of women in this tertiary care setting have FSD, with 1718 women we had 80% power to detect an odds ratio (OR) of 1.15 or more.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Cronbach α for the MAAS in the current sample was 0.92.
“The Cronbach α for the current sample was 0.92.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: MAAS scores reflect innate mindfulness.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Cronbach α for the FSDS-R in the current sample was 0.96.
“The Cronbach α for the current sample was 0.96.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataAmong women for whom menopause status was available, age was highly associated with menopause status (P<.001) and had fair collinearity (variance inflation factor = 2).
“Among women for whom menopause status was available, age was highly associated with menopause status (P<.001), with fair collinearity between the two (variance inflation factor = 2).”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).
Study design and conductown dataThe Cronbach α for the GAD-7 in the current sample was 0.92.
“The Cronbach α for the current sample was 0.92.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Study design and conductreasoningThe cross-sectional design means the observed associations between mindfulness and FSD are associative and causality cannot be determined.
“The limitations of the study include its cross-sectional design, in that correlations between higher mindfulness and lower FSD are associative, and causality cannot be determined.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductown dataThe study did not collect data on prior mindfulness training.
“We did not collect data on prior mindfulness training.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationA small study showed a correlation of higher trait mindfulness with a range of positive sexual outcomes for both partnered and unpartnered individuals.
“Among the few available studies in the literature, a small study showed a correlation of higher trait mindfulness with a range of positive sexual outcomes for both partnered and unpartnered individuals [22].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [22] Pepping, 2018, The effects of mindfulness on sexual outcomes: the role of emotion regulation, Arch. Sex. Behav. source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationHigher MAAS scores correlate positively with positive affect, openness, awareness, and well-being, and negatively with anxiety, stress, rumination, and neuroticism.
“Higher MAAS scores correlate positively with positive affect, openness, awareness, and well-being, and correlate negatively with anxiety, stress, rumination, and neuroticism [18].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [18] Brown, 2003, The benefits of being present: mindfulness and its role in psychological well-being, J. Pers. Soc. Psychol. source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationExisting research has demonstrated a positive relationship between trait mindfulness and reduced stress sensitivity, better adaptability, and improved psychological well-being.
“Existing research has demonstrated a positive relationship between trait mindfulness and reduced stress sensitivity, better adaptability, and improved psychological well-being [18].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [18] Brown, 2003, The benefits of being present: mindfulness and its role in psychological well-being, J. Pers. Soc. Psychol. source
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Cronbach α for the PHQ-9 in the current sample was 0.85.
“The Cronbach α for the current sample was 0.85.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationAn FSDS-R score of 11 or higher reflects substantial distress associated with sexual complaints.
“scores of 11 or higher are reflective of substantial distress associated with sexual complaints [17].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Derogatis, 2008, Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder, J. Sex. Med. source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationHigher levels of trait mindfulness have been linked to better self-care behaviors, physical health, psychological outcomes, relationships, intimate relationship satisfaction, and response to relationship stress.
“Higher levels of trait mindfulness have been linked to better self-care behaviors, physical health, psychological outcomes, relationships, intimate relationship satisfaction, and response to relationship stress [7, 13].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [7] Kabat-Zinn, 1990
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [13] Barnes, 2007, The role of mindfulness in romantic relationship satisfaction and responses to relationship stress, J. Marital Fam. Ther. source
Classified as probably not a substantial claim.
PremisecitationIn an 8-week study of a mindfulness-based intervention, individuals with higher levels of trait mindfulness showed larger and more persistent increases in their mindfulness after training.
“In an 8-week study of a mindfulness-based intervention, individuals with higher levels of trait mindfulness showed larger and more persistent increases in their mindfulness after training [30].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [30] Shapiro, 2011, The moderation of Mindfulness-based stress reduction effects by trait mindfulness: results from a randomized controlled trial, J. Clin. Psychol. source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationIn a third study, mindfulness was estimated to explain 54% of variability in sexual distress.
“In a third study, mindfulness was estimated to explain 54% of variability in sexual distress [23].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [23] Adam, 2015, Mindfulness skills are associated with female orgasm?, Sex. Relation. Therapy source
The paper relies on this without support.
The association between FSD and trait mindfulness is not well understood.
“The association of FSD and trait mindfulness is not well understood.”
The paper relies on this without support.
This is the largest cross-sectional study to assess the association between dispositional or trait mindfulness and FSD.
“To the best of our knowledge, this is the largest cross-sectional study to assess the association between dispositional or trait mindfulness and FSD.”
The authors state this as an assumption.
MAAS scores reflect innate mindfulness.
“Our assumption that MAAS scores reflect innate mindfulness was based on low population prevalence of mindfulness training in previous large surveys [31].”
The paper relies on this without support.
The current study is unique in evaluating the effects of trait mindfulness on FSD.
“The current study is unique in evaluating the effects of trait mindfulness on FSD.”
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- Authors
- Sood, R., Kuhle, C. L., Thielen, J. M., Kapoor, E., Vencill, J. A., Mara, K. C., & Faubion, S. S.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Sood, Richa
- ORCID
- Venue
- Maturitas
- Publisher
- Elsevier BV
- Published
- 2022-07
- Volume
- 161
- Pages
- 27-32
- ISSN
- 0378-5122 (ISSN-L)
- PMC
- PMC11309572
- OpenAlex
- W4213296203
- Cited by
- 15
- References
- 28
- Citations by year
- 2025: 8 · 2024: 5 · 2023: 2
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 236 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Maturitas (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (U54AG044170)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Keywords
- female sexual dysfunction, mindfulness, trait mindfulness, sexual function, sexual distress, Mindfulness Attention Awareness Scale, Female Sexual Function Index, Female Sexual Distress Scale-Revised, women's health
- MeSH terms
- Cross-Sectional Studies, Female, Humans, Surveys and Questionnaires, Sexual Behavior, Sexual Dysfunctions, Psychological, Mindfulness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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