Document Type : Original Article


1 Department of Midwifery and Reproductive Health, Tarbiat Modares University, Tehran, Iran,

2 Department of Midwifery, Faculty of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran

3 Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran


BACKGROUND: Female sexual dysfunction is a common and often distressing public health problem.
This study aimed to determine the effect of the sexual health program on female sexual function and
attitude in reproductive age in the west of Iran.
MATERIALS AND METHODS: This was a field trial study. A total of 103 women attending health
centers were assigned into two groups; an experiment and a control group. Data collection tool involved
sociodemographic characteristics questionnaire, sexual female attitude questionnaire, and the Female
Sexual Function Index (FSFI), which was completed by participants before and after the implementation
of a sexual health education program. Data were analyzed using SPSS software version 22.
RESULTS: The results revealed that after the intervention, female sexual function in the experiment
group based on the FSFI tool was significantly improved (P < 0.01) in the domains of desire, arousal,
orgasm, satisfaction, pain, and the total score compared with the control group. Besides, there was
no significant difference between posttest mean score of sexual attitude in the experiment group and
control group (P > 0.05). However, a significant difference was found in the mean score of sexual
attitudes in the experimental group before and after the intervention (P = 0.004).
CONCLUSION: The findings showed that sexual health program was effective in improving women’s
sexual function and attitude in the experiment group. It is recommended that the effect of other training
methods remain to be addressed on women’s sexual function and attitude.


  1. Douglas JM Jr., Fenton KA. Understanding sexual health and its
    role in more effective prevention programs. Public Health Rep
    2013;128 Suppl 1:1-4.
    2. Rezaei N, Janani F, Sharifi N, Omidi F, Azadi A. Sexual Function
    and quality of life among postpartum women: A cross-sectional
    study. Int J Womens Health Reprod Sci 2018;6:307-12.
    3. Flynn KE, Lin L, Bruner DW, Cyranowski JM, Hahn EA,
    Jeffery DD, et al. Sexual satisfaction and the importance of sexual
    health to quality of life throughout the life course of U. S. adults.
    J Sex Med 2016;13:1642-50.
    4. Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C,
    Byers ES, et al. Psychological and Interpersonal dimensions of
    sexual function and dysfunction. J Sex Med 2016;13:538-71.
    5. McCool-Myers M, Theurich M, Zuelke A, Knuettel H,
    Apfelbacher C. Predictors of female sexual dysfunction:
    A systematic review and qualitative analysis through gender
    inequality paradigms. BMC Womens Health 2018;18:108.
    6. Damari B, Tabrizchi N, Riazi-Isfahani S. Designing a national plan
    for improving sexual health in Iran: An experience of an Islamic
    country. Med J Islam Repub Iran 2016;30:407.
    7. Mohammadian S, Dolatshahi B. Sexual problems in Tehran:
    Prevalence and associated factors. J Educ Health Promot
    8. Nasehi AA, Raisi F, Ghaeli P, Amini M, Yahyavi ST,
    Arabkheradmand J, et al. Prevalence of sexual dysfunction among
    general population of Iran: A systematic review. Iran J Psychiatry
    Behav Sci 2017;11:e7643.
    9. Basirnia A, Sahimi-Izadian E, Arbabi M, BayayZ, Vahid-Vahdat S,
    Noorbala AA, et al. Systematic review of prevalence of sexual
    disorders in Iran. Iran J Psychiatry 2007;2:151-6.
    10. Ghanbarzadeh N, Nadjafi-Semnani M, Ghanbarzadeh MR,
    Nadjfai-Semnani A, Nadjfai-Semnani F. Female sexual
    dysfunction in Iran: Study of prevalence and risk factors. Arch
    Gynecol Obstet 2013;287:533-9.
    11. ShahhosseiniZ, GardeshiZH, Pourasghar M, Salehi F. A review of
    affecting factors on sexual satisfaction in women. Mater Sociomed
    12. Ford JV, Barnes R, Rompalo A, Hook EW 3rd. Sexual health
    training and education in the U. S. Public Health Rep 2013;128
    Suppl 1:96-101.
    13. Hogben M, Ford J, Becasen JS, Brown KF. A systematic review of
    sexual health interventions for adults: Narrative evidence. J Sex
    Res 2015;52:444-69.
    14. Mapp F, Wellings K, Hickson F, Mercer CH. Understanding sexual
    healthcare seeking behaviour: Why a broader research perspective
    is needed. BMC Health Serv Res 2017;17:462.
    15. World Health Organization. Defining Sexual Health: Report of
    a Technical Consultation on Sexual Health, 28-31 January 2002.
    Geneva: World Health Organization; 2006.
    16. Rezaei N, Azadi A, Sayehmiri K, Valizadeh R. Postpartum sexual
    functioning and its predicting factors among Iranian women.
    Malays J Med Sci 2017;24:94-103.
    17. Baradaran-Akbarzadeh N, Tafazoli M, Mojahedi M, Mazlom SR.
    The effect of educational package on sexual function in cold
    temperament women of reproductive age. J Educ Health Promot
    18. Masoumi SZ, Kazemi F, Nejati B, Parsa P, Karami M. Effect
    of sexual counseling on marital satisfaction of pregnant
    women referring to health centers in Malayer (Iran): An
    educational randomized experimental study. Electron Physician
    19. Merghati Khoei E, Alavi T, Maasoumi R, Sheikhan F.
    Elements associated with Iranian women’s sexual behaviours:
    Across-sectional study. Int J Reprod Biomed(Yazd) 2018;16:349-54.
    20. Behboodi Moghadam Z, Rezaei E, Khaleghi Yalegonbadi F,
    Montazeri A, Arzaqi SM, Tavakol Z, et al. The effect of sexual
    health education program on women sexual function in Iran.
    J Res Health Sci 2015;15:124-8.
    21. Tayerih K, Bayat Jozani Z, Golchehregan H, Rostam-Afshar Z,
    Taj L, Ahsani Nasab S, et al. Woman’s sexual health knowledge
    and needs assessment in behavioral clinics and shelters in Tehran.
    J Family Reprod Health 2019;13:26-34.
    22. Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H.
    Effects of sex education and kegel exercises on the sexual function
    of postmenopausal women: A randomized clinical trial. J Sex Med
    23. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R,
    et al. The Female Sexual Function Index (FSFI): Amultidimensional
    self-report instrument for the assessment of female sexual
    function. J Sex Marital Ther 2000;26:191-208.
    24. Hashemi S, Ramezani Tehrani F, Simbar M, Abedini M,
    Bahreinian H, GholamiR. Evaluation of sexual attitude and sexual
    function in menopausal age; a population based cross-sectional
    study. Iran J Reprod Med 2013;11:631-6.
    25. Kim HY, Park M, Lee E. A cross-sectional survey of relationships
    between sexual knowledge, sexual attitudes, and reproductive
    health behaviour among female university students. Contemp
    Nurse 2018;54:640-50.
    26. Li S, Chen R, Cao Y, Li J, Zuo D, Yan H. Sexual knowledge,
    attitudes and practices of female undergraduate students in
    Wuhan, China: The only-child versus students with siblings.
    PLoS One 2013;8:e73797.
    27. Sadat Z, Ghofranipour F, Azin SA, Montazeri A, Goshtasebi A,
    Bagheri A, et al. Development and psychometric evaluation
    of the sexual knowledge and attitudes scale for premarital
    couples (SKAS-PC): An exploratory mixed method study. Int J
    Reprod Biomed (Yazd) 2018;16:41-50.
    28. Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J
    Med Educ 2011;2:53-5.
    29. Mohammadi KH, Heydari M, Faghihzade S. Validity of the
    persian version of the female sexual function index (FSFI) as an
    indicatorof women’s sexualfunction. Payesh 2008;7:269-78.
  2. 30. Fakhri A, Pakpour AH, Burri A, Morshedi H, ZeidiIM. The female
    sexual function index: Translation and validation of an Iranian
    version. J Sex Med 2012;9:514-23.
    31. Mahnaz E, Nasim B, Sonia O. Effect of a structured educational
    package on women’s sexual function during pregnancy. Int J
    Gynaecol Obstet 2020;148:225-30.
    32. Adams NE. Bloom’s taxonomy of cognitive learning objectives.
    J Med Libr Assoc 2015;103:152‑3