When treating sexual dysfunction in women, placebo pills alone have shown a significant effect on the response; however, the reasons for this are unknown. In a 12-week study on female sexual arousal disorder (FSAD), almost one-third of the placebo group showed considerable improvement in symptoms. This was directly linked to an increase in the number of satisfying sexual events. The study’s design and procedures seemed to contribute more to the improvements in the women that were observed, rather than baseline factors.
Interpreting the response to a placebo pill involves focusing on the result of the treatment, where factors other than the drug itself cause the benefit. Placebo administration has shown considerable effect in women’s sexual dysfunction according to studies, but not much is known about predictors of this response. It is believed that any modification in the patients’ behavioral patterns could positively influence placebo response, especially in treating sexual disorders. The goal of this trial was to verify whether intensity of symptoms varies with recent sexual activity, during particularly satisfying events. Additionally, the response in the placebo group was quantified based on individual variables during the study.
- Fifty premenopausal women (35 to 55 years old) taking placebos for female sexual arousal disorder were asked to attempt sexual activity at stipulated points during a 24-hour period.
- Female sexual function index (FSFI), sexual activity record (SAR) and female sexual distress scale (FSDS) were used by the participants to record the level of sexual dysfunction, their sexual activity and any distress caused due to sexual activity respectively.
- The frequency and satisfaction of sexual activity and distress experienced were used as predictors. Statistical analyses were carried out to understand the changes in behavior that helped symptom improvement.
- The sexual function index saw an increase from 17.98 at baseline to 23.80 post-treatment (indicating sexual satisfaction) with the values strongly corresponding to symptom reduction.
- About 34.9 percent subjects recorded both definite and significant change in their dysfunction symptoms while nearly 60.5 percent showed definite change.
- Entries of lower satisfaction at baseline showed greater change by the end of the treatment.
- Satisfying sexual encounters was the best measure of functional outcome in the treatment of sexual disorders, as opposed to frequency of sexual encounters.
One of the shortcomings of this study was the lack of follow up to see if the benefits were continued in the long term. Moreover in this study, the changes in behavior and symptoms were not compared between the active treatment group and the placebo group. Further studies should incorporate between-group analyses. Finally, the changes observed could also be due to the natural history of the disease itself. These need to be determined when conducting future studies.
The researchers found that more than a woman’s age or the severity of her symptoms, it was the change in her sexual behavior that determined the ultimate result of the trial. This study helps to conclude that satisfying sexual behavior and functional results are definitely related in women receiving placebo treatment for sexual dysfunction. However, measuring the placebo effect could be for various reasons pertaining to each subject or the disease course itself. It is very important to estimate whether the same effect is observable in the absence of the treatment or whether the result is only due to the psychological effect of the placebo in a blind study.
For More Information:
Behavior and Symptom Change among Women Treated with Placebo for Sexual Dysfunction
Publication Journal: The Journal of Sexual Medicine, September 2010
By Andrea Bradford, PhD; Cindy M. Meston, PhD; Baylor College of Medicine, Houston, Texas; Houston Center for Quality of Care and Utilization Studies, Houston, Texas and Department of Psychology, University of Texas at Austin