More than half of the female population suffers from cyclical mastalgia, which can interfere with sexual functioning and impact sexual satisfaction and cause sexual distress. The present study evaluated the efficacy of mindfulness-based cognitive therapy (MBCT) counseling on sexual satisfaction and sexual distress among married women with cyclical mastalgia.

A randomized controlled clinical trial was conducted in 2024 with 72 married women presenting with cyclical breast pain at comprehensive health centers in Qazvin, Iran. Participants were randomly allocated via quadruple block randomization with allocation concealment using sealed opaque envelopes, into an intervention group (n = 36) receiving eight 90-min MBCT sessions and a control group (n = 36) receiving no intervention. Demographic-obstetric questionnaires, the Visual Analogue Scale (VAS) for pain, the Cardiff Breast Pain Chart, the Female Sexual Satisfaction and Distress Scale, and the Five-Facet Mindfulness Questionnaire were completed by all participants at baseline and at one- and three-month follow-ups. Data were analyzed using repeated-measures analysis of covariance (ANCOVA) in SPSS-27, with statistical significance set at p < 0.05.

The intervention group demonstrated significant improvements across all measured outcomes compared to controls. For sexual satisfaction, mean score differences between groups (baseline, first, and second follow-ups, respectively) were as follows: sexual satisfaction subscale (0.08, 4.49, 6.72; p < 0.001), relationship subscale (0.56, 4.17, 6.56; p < 0.001), and compatibility subscale (−0.33, 4.15, 7.61; p < 0.001). Similarly, sexual distress scores showed marked reductions in relational concern (−0.22, 5.24, 8.33; p < 0.001) and personal concern subscales (−0.97, 3.41, 7.74; p < 0.001). Mindfulness scores increased substantially among those in the intervention group (0.11, 10.02, 15.31; p < 0.001), while pain intensity scores decreased (−0.07, −1.67, −1.69; p < 0.001), indicating both psychological and symptomatic benefits. All changes were statistically significant at one- and three-month follow-ups, confirming the sustained efficacy of MBCT counseling.

The findings suggest that MBCT could be considered as a complementary therapy in managing cyclical mastalgia, particularly for women experiencing sexual dysfunction. Future research to assess long-term effects and compare MBCT with other therapeutic approaches are recommended.