Tele-emotion regulation therapy versus tele-guided imagery therapy on sexual performance anxiety in endometrial and ovarian cancer - a randomized clinical trial

Sep 22, 2026

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Advancements in cancer care have improved survival, yet sexual anxiety remains under-studied among women with gynecologic cancers facing both physical consequences (pain, drugs, surgery) and psychological consequences (shame, fear, anxiety). A randomized parallel clinical trial compared Emotion Regulation Therapy (ERT) with Guided Imagery Therapy (GIT). Online counseling (eight sessions, 60 minutes each) assessed sexual anxiety via Davis questionnaire at baseline, week 8, and week 12, with partner satisfaction measured in weeks 8 and 12. Results showed significant within-group reductions by week 12, with no significant between-group difference; partner satisfaction remained high. Conclusions supported both approaches for improving sexual anxiety in relevant clinical contexts.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Trial details and ethics

Trial registration and ethics code

Keywords

Background context

Ansari et al. BMC Cancer (2026) 26:578 BMC Cancer [https://doi.org/10.1186/s12885-025-15180-y](https://doi.org/10.1186/s12885-025-15180-y) RESEARCH Open Access Tele-emotion regulation therapy versus tele-guided imagery therapy on sexual performance anxiety in endometrial and ovarian cancer: a randomized clinical trial Farinaz Ansari1, Tahmineh Farajkhoda2*, Fahimeh Nokhostin3, Hassan Zareei Mahmoodabadi4 and Mohammadtaghi Sarebanhassanabadi5 Abstract Background Advancements in cancer treatment have led to increasing life expectancy. Few studies have been conducted on sexual anxiety in women affected by gynecologic cancers who suffer from physical (pain, drugs, & surgery) and psychological (shame, fear, & anxiety) consequences. This study aimed to compare Emotion Regulation Therapy (ERT) versus Guided Imagery Therapy (GIT) on sexual anxiety in these women. Methods A randomized parallel clinical trial was conducted on 64 eligible women who were randomly assigned into either ERT (intervention 1 = 32) or GIT groups (intervention 2 = active control group= 32) . Each group received eight 60-min online counseling sessions. The main outcome variable of sexual anxiety was investigated via the Davis questionnaire at baseline, in week 8, and the follow-up in week 12. The secondary outcome variable, i. e., husband’s satisfaction with sexual relationship, was measured in weeks 8 and 12. Results Intra-group comparison of sexual performance anxiety showed significant decrease in week 12 compared to baseline (ERT: 35.97 ± 5 . 84, & 61.16 ± 13 . 84; P = 0 . 001) (GIT: 35.55 ± 4 . 79, & 59.84 ± 11 . 54; P = 0 . 001), respectively. Intergroup comparison of sexual performance anxiety showed that the scores decreased in both groups in week 12 (ERT: 35.97 ± 5.84 versus GIT: 35.55 ± 4 . 79) without significant difference (P = 0 . 297) . Intra-group comparison of husband’s satisfaction indicated that it was high in both groups without significant difference (ERT week 8: 8.77 ± 1 . 61, week 12: 9.00 ± 1 .41; P = 0 .412),(GIT week 8: 8.74 ± 1 . 00, week 12: 9.16 ± 0 . 78; P = 0 . 130), respectively. Inter-group comparison between week 8 (P = 0 . 297) and week 12 (P = 0 . 910) showed no significant difference. Conclusions Online ERT and GIT were both able to improve sexual anxiety with appropriate partner’s satisfaction in these women. Such interventional supports provide more options for better quality of life, especially for women who are unwilling to take psychiatric medications or in other anxiety-provoking situations to reduce anxiety. The application of the findings in the clinical context is related to its usefulness in the integration of care guidelines and treatment plans for these women, as well as by sex therapists, health providers, and health policy-makers. *Correspondence: Tahmineh Farajkhoda[farajkhoda_t@yahoo.com](farajkhoda_t@yahoo.com) Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creat

FAQs

What was the study’s main goal?

To compare Emotion Regulation Therapy (ERT) versus tele-guided Imagery Therapy (GIT) for sexual anxiety/sexual performance anxiety in women with endometrial and ovarian cancer.

How were participants allocated and what interventions were delivered?

Sixty-four eligible women were randomly assigned to ERT or GIT. Each group received eight online counseling sessions, each lasting 60 minutes.

What outcomes were measured and when?

Sexual anxiety was measured using the Davis questionnaire at baseline, week 8, and week 12. Husband’s satisfaction with the sexual relationship was measured in weeks 8 and 12.

What did the results show about anxiety and partner satisfaction?

Sexual performance anxiety decreased significantly by week 12 within both groups, and between-group differences were not significant. Husband’s satisfaction was high in both groups with no significant differences across time points.

Sep 22, 2026

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