THE EFFECT OF SEXUAL COUNSELING BASED ON THE EXPLISSIT MODEL ON SEXUAL FUNCTION, MARITAL ADJUSTMENT, AND QUALITY OF SEXUAL LIFE IN POSTMENOPAUSAL WOMEN

May 12, 2026 updated by: Serap Kırıcı, Karamanoğlu Mehmetbey University

THE EFFECT OF SEXUAL COUNSELING BASED ON THE EXPLISSIT MODEL ON SEXUAL FUNCTION, MARITAL ADJUSTMENT, AND QUALITY OF SEXUAL LIFE IN POSTMENOPAUSAL WOMEN: A RANDOMIZED CONTROLLED STUDY

Sexual health is not merely about sexual dysfunction, but a complex, diverse, and multifaceted natural process encompassing a wide range of aspects of human life, extending from childhood to old age. Quality of sexual life refers to an individual's satisfaction with their sexual life. Due to increased life expectancy, women spend more than a third of their lives in the postmenopausal period. Contrary to expectations, sexuality becomes increasingly important for women in the postmenopausal period. The postmenopausal period, following menopause, brings about vasomotor, psychological, and urogenital changes and complaints, as well as various health problems. These changes and complaints can impair sexual function, sexual satisfaction, and marital harmony, negatively impacting the quality of sexual life. The literature indicates that sexual satisfaction is one of the most important factors affecting marital harmony, and that sexual dissatisfaction diminishes positive emotions and intimacy within marriage. The postmenopausal period has a significant impact not only on life expectancy but also on couples' sexual health and marital harmony. However, the assessment of this issue by healthcare personnel is often neglected. Assessing patients' sexual health and concerns about sexuality is an important part of the professional nursing role and holistic care. For this purpose, it is stated that participation in special training programs aimed at assessing patient sexuality and the use of models that will provide guidance can be beneficial . The use of professional sexual diagnostic models by nurses in assessing patient sexuality will lead to a healthier and more effective questioning and evaluation of sexuality. The PLISSIT and EX-PLISSIT models are commonly used by nurses in primary care to address sexual health needs and concerns. The PLISSIT model consists of four therapeutic stages: Permission, Limited Information (LI), Specific Suggestions (SS), and Intensive Therapy (IT). As the intervention stages of the PLISSIT model progress, more comprehensive knowledge, training, and skills are required. Ex-PLISSIT is an expanded version of the PLISSIT model, with the permission stage being central. One cannot proceed to the next stage without completing the permission stage

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

86

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being sexually active
  • Living with a spouse/partner
  • Having at least a primary school diploma
  • Being in the postmenopausal period
  • Agreeing to participate in the study
  • Having entered menopause naturally
  • Scoring ≤26.55 on the FSFI scal

Exclusion Criteria:

  • Being on Hormone Replacement Therapy (HRT) and not having discontinued HRT treatment at least six months prior to the study
  • Having undergone surgical menopause
  • Not having entered menopause at an early or late age (over 40 and under 55 years of age)
  • Having a chronic systemic disease and/or a psychiatric health problem
  • Having a disability that makes communication difficult, such as hearing or language problems
  • Having received any sexual counseling before the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: control group
The control group will not receive any intervention. They will only be given educational brochures.
Experimental: experimental group
The group that received sexual education based on the EX PLISSIT model
Other: Group receiving sexual counseling based on the EX PLISSIT model.
Appointments will be scheduled for the women in the intervention group to meet at a convenient time and in a suitable environment at the hospital. Sexual counseling within the intervention group will be planned and implemented according to the 4 stages of the EX-PLISSIT model, focusing on the patients' sexual health. Counseling sessions will be conducted by a nurse specializing in sexuality (first author) with a sexual counseling certificate, under the direct supervision of a faculty member specializing in obstetrics and gynecology nursing (second author). The intervention consisted of 4 counseling sessions, each lasting 60-90 minutes, once a week for four weeks. All sessions will be conducted face-to-face and individually in a private room.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Measuring the impact of sexual counseling based on the EX PLISSIT model
Time Frame: two months

After sexual counseling based on the EX PLISSIT model, the Female Sexual Function Index (FSFI) scale were administered to women in the experimental and control groups via face-to-face interviews. The administration time for each scale varied between 15 and 20 minutes.

Changes in the Female Sexual Function Index (FSFI) scale were measured two months after sexual counseling based on the EX PLISSIT model.

Female Sexual Function Index (FSFI) This is a 19-item multidimensional scale for evaluating female sexual function. The scale includes six subheadings, desire, arousal, lubrication, orgasm, satisfaction, and pain. Each title was scored between 0 or 1 and six. The lowest and highest scores are 2 and 36, respectively. Higher scores indicated better sexual function. The cut-off value of the scale was 26.55. A total FSFI score of ≤26.55, it indicates sexual dysfunction
two months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Measuring the impact of sexual counseling based on the EX PLISSIT model
Time Frame: two months

After sexual counseling based on the EX PLISSIT model, the Sexual Quality of Life-Female (SQoL-F) scale were administered to women in the experimental and control groups via face-to-face interviews. The administration time for each scale varied between 15 and 20 minutes.

Changes in the Female Sexual Quality of Life (SQoL-F) scales were measured two months after sexual counseling based on the EX PLISSIT model.

Sexual Quality of Life-Female (SQoL-F): It is a 6-point Likert-type scale consisting of 18 items. Respondents consider their sexual life over the past four weeks. Scores range from 18 to 108. Higher scores indicate better sexual quality of life.
two months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Karamanoğlu Mehmetbey University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 1, 2026

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

September 1, 2026

Study Registration Dates

First Submitted

April 23, 2026

First Submitted That Met QC Criteria

April 23, 2026

First Posted (Actual)

April 30, 2026

Study Record Updates

Last Update Posted (Actual)

May 15, 2026

Last Update Submitted That Met QC Criteria

May 12, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DECISION 02-2026/43

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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