Qualitative Findings from a Pilot Trial of Mindfulness for Low Sexual Desire in Midlife and Older Women

Low libido is a common and potentially distressing problem among midlife and older women. We recently reported results from a pilot randomized controlled trial of a mindfulness intervention for midlife and older cisgender women with low libido; the purpose of this qualitative investigation is to illustrate women's experiences with being recruited for, enrolling in, and participating in the trial. We conducted individual interviews with a subset of trial participants, some of whom attended a group-based mindfulness intervention and some attended an educational control group (N = 25). We also interviewed participants who were enrolled but did not attend any groups (N = 9). A semi-structured interview guide was developed by the study team. A co-investigator with qualitative research expertise and the primary investigator conducted interviews, which were audio recorded and transcribed. We used a thematic analysis approach to analysis, co-coding a subset of interviews to develop and refine a codebook, then assigning codes to all data. Codes were grouped into subthemes and themes and key insights were extracted. Three key themes emerged from women who attended groups. First, women were interested in the intersection of sexuality and mindfulness. Second, women in both groups valued the sense of community they gained from participating; the interactive nature of sessions contributed to this. Third, experiences with attending groups over videoconferencing software were largely positive. Suggestions for improvement included a better explanation of the randomization process and more didactic information about sexuality and aging in both groups. Non-attendees listed time conflicts as their top reason for not attending. We recommend researchers consider utilizing a group format when designing behavioral interventions for midlife and older women, as this design offers many benefits for participants, but ensuring that a qualified professional is present can ensure information exchanges is evidence-based. In addition, healthcare systems can consider building in opportunities for midlife women to gather and exchange information regarding health.