Original Article

The Effectiveness of Auriculotherapy on Women's Sexual Function: A Randomized Controlled Trial


Objective: Majority of breastfeeding women experience changes in sexual function. The present study was designed to assess effectiveness of auriculotherapy on improving sexual function in breastfeeding women.

Method: In this randomized sham controlled trial, accomplished from January 2018 to May 2019 in a referral sexual health clinic in city of Qom, Iran, 60 eligible participants were assigned to either intervention and control groups via block randomization. In the intervention group, electrical stimulation was applied for 15 seconds on Shen Men, Zero, Thalamic, Master Cerebral, Libido, Relax, Excitement, Ovary, and Uterus points in 10 auriculotherapy sessions. Then, Vaccaria seeds were stuck on these points. The control group received the same procedure with the device off as a sham method. Data were gathered using the Female Sexual Function Index (FSFI) at three different time points.

Results: At baseline, mean scores of sexual function dimensions were not significantly different between the intervention and control groups except for orgasm. Post-intervention, the results showed significant differences in sexual desire (P = 0.002), sexual arousal (P = 0.008), lubrication (P = 0.001), sexual satisfaction (P = 0.001), and orgasm (P = 0.009). One month after the intervention, the results showed significant differences in sexual desire, sexual arousal, lubrication, sexual satisfaction (P = 0.001), orgasm (P = 0.006), and dyspareunia (P = 0.015). Differences in mean score of sexual function in post-intervention and one-month follow-up were only significant in the intervention group (P = 0.001).

Conclusion: Based on evidence from this study, auriculotherapy is an effective technique for improving sexual function in breastfeeding women.

1. Zaheri F, Dolatian M, Shariati M, Simbar M, Ebadi A, Azghadi SB. Effective Factors in Marital Satisfaction in Perspective of Iranian Women and Men: A systematic review. Electron Physician. 2016;8(12):3369-77.
2. El-Kashif M, El-tahry SE. A study of sexual dysfunction and its associated factors among women in childbearing age, Egypt. J Nurs Educ Pract. 2019;9:95-108.
3. Dadgar S, Karimi FZ, Bakhshi M, Abdollahi M, Rahimzadeh Borj F. Assessment of sexual dysfunction and its related factors in pregnant women referred to Mashhad health centers (2017-2018). Iran J Obstet Gynecol Infertil. 2018;21(8):22-9.
4. El-Sayed HAE, Ramadan S, Ibrahim H, Moursi HAA. The effect of mode of delivery on postpartum sexual function and sexual quality of life in primiparous women. Am J Nurs Sci. 2017;6(4):347-57.
5. Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Asghari-Jafarabadi M, Tavananezhad N, Karkhaneh M. Modeling of socio-demographic predictors of sexual function in women of reproductive age. J Mazandaran Univ Med Sci. 2014 Mar 23([110):238-42(Persian).
6. Dor Mohammadi M, Jafarnezhad F, Aghayi MA, Kazemeini H. Investigating the relationship between sexual function and obesity in women. Iran J Obstet Gynecol Infertil. 2012;15(24):26-33.
7. Laganà AS, Burgio MA, Ciancimino L, Sicilia A, Pizzo A, Magno C, et al. Evaluation of recovery and quality of sexual activity in women during postpartum in relation to the different mode of delivery: a retrospective analysis. Minerva Ginecol. 2015;67(4):315-20.
8. Hosseini L, Iran-Pour E, Safarinejad MR. Sexual function of primiparous women after elective cesarean section and normal vaginal delivery. Urol J. 2012;9(2):498-504.
9. Khajehei M. Prevalence and Risk Factors of Relationship Dissatisfaction in Women During the First Year After Childbirth: Implications for Family and Relationship Counseling. J Sex Marital Ther. 2016;42(6):484-93.
10. Ahmad Shirvani M, Bagheri Nesami M. Sexual dysfunction and related factors among breast feeding women. Iran J Obstet Gynecol Infertil.2011; 1(5):36-2.
11. Alligood-Percoco NR, Kjerulff KH, Repke JT. Risk Factors for Dyspareunia After First Childbirth. Obstet Gynecol. 2016;128(3):512-8.
12. Holanda JBdL, Abuchaim EdSV, Coca KP, Abrão ACFdV. Sexual dysfunction and associated factors reported in the postpartum period. ACTA Paul Enferm.. 2014;27:573-8.
13. Rezaei N, Azadi A, Sayehmiri K, Valizadeh R. Postpartum Sexual Functioning and Its Predicting Factors among Iranian Women. Malays J Med Sci. 2017;24(1):94-103.
14. McDonald E, Woolhouse H, Brown SJ. Consultation about Sexual Health Issues in the Year after Childbirth: A Cohort Study. Birth. 2015;42(4):354-61.
15. Torkzahrani S, Banaei M, Ozgoli G, Azad M, Emamhadi MA. Postpartum sexual function; conflict in marriage stability: a systematic review. IJMTFM. 2016; 6(2):88-98.
16. Hezbiiyan Z, Khodakarami B, Parsa P, Faradmal MJ. The effect of postnatal counseling on sexual function in women referred to health centers in Hamedan in 1392. Avicenna J Nurs Midwifery Care. 2016; 24(4):272-80.
17. Khajehei M, Doherty M, Tilley PM, Sauer K. Prevalence and Risk Factors of Sexual Dysfunction in Postpartum A ustralian Women. J Sex Med. 2015;12(6):1415-26.
18. Anzaku A, Mikah S. Postpartum resumption of sexual activity, sexual morbidity and use of modern contraceptives among nigerian women in jos. Ann Med Health Sci Res. 2014;4(2):210-6.
19. Hipp LE, Kane Low L, van Anders SM. Exploring women's postpartum sexuality: social, psychological, relational, and birth-related contextual factors. J Sex Med. 2012;9(9):2330-41.
20. Bień A, Rzońca E, Iwanowicz-Palus G, Lenkiewicz E. Factors affecting sexual activity of women after child-birth. JPHNMR. 2016;184:58-66.
21. Radziah M, Shamsuddin K, Jamsiah M, Normi M, Zahari TM, Syimah AN, et al. Early resumption of sexual intercourse and its determinants among postpartum Iban mothers. Int J Reprod Contracept Obstet Gynecol. 2013;2(2):124-30.
22. Acele E, Karaçam Z. Sexual problems in women during the first postpartum year and related conditions. J Clin Nurs. 2012;21(7-8):929-37.
23. Chauhan NS, Sharma V, Dixit VK, Thakur M. A review on plants used for improvement of sexual performance and virility. Biomed Res Int. 2014;2014:868062.
24. Frühauf S, Gerger H, Schmidt HM, Munder T, Barth J. Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Arch Sex Behav. 2013;42(6):915-33.
25. Cooper K, Martyn-St James M, Kaltenthaler E, Dickinson K, Cantrell A, Ren S, et al. Complementary and Alternative Medicine for Management of Premature Ejaculation: A Systematic Review. Sex Med. 2017;5(1):e1-e18.
26. Oleson T. Auriculotherapy manual: Chinese and western systems of ear acupuncture. In: Auriculotherapy treatment protocol. 4th ed, Elsevier Health Sciences Inc.2014. pp.392-94.
27. Mousavi FS, Golmakani N, Bahrami Taghanaki HR, Saki A, Akhlaghi F. Effects of auriculotherapy on post cesarean anxiety. Iran J Obstet Gynecol Infertil. 2017;20(6):50-60.
28. Cho SH, Hwang EW. Acupuncture for primary dysmenorrhoea: a systematic review. Bjog. 2010;117(5):509-21.
29. Cui X, Zhou J, Qin Z, Liu Z. Acupuncture for Erectile Dysfunction: A Systematic Review. Biomed Res Int. 2016;2016:2171923.
30. Vas J, Modesto M, Aguilar I, Gonçalo Cda S, Rivas-Ruiz F. Efficacy and safety of auriculopressure for primary care patients with chronic non-specific spinal pain: a multicentre randomised controlled trial. Acupunct Med. 2014;32(3):227-35.
31. Wang MC, Hsu MC, Chien LW, Kao CH, Liu CF. Effects of auricular acupressure on menstrual symptoms and nitric oxide for women with primary dysmenorrhea. J Altern Complement Med. 2009;15(3):235-42.
32. Valiani M, Khaki I, Shahshahan Z, Sirus M. Effect of auriculotherapy on menstrual irregularities in single girls with polycystic ovarian syndrome and aged 18-35 years in Isfahan in 2012. Iran J Nurs Midwifery Res. 2015;20(2):190-4.
33. Tsai MY, Liu CT, Chang CC, Chen SY, Huang ST. Overview of the relevant literature on the possible role of acupuncture in treating male sexual dysfunction. Acupunct Med. 2014;32(5):406-10.
34. Soliman N. The Garden of Earthly Delights: Treating human sexuality through auricular therapy. Med Acupunct. 2008;20(1):43-5.
35. Ghana S, Jouybari LM, Sanagoo A. Exploration of Women's Sexual Experiences during Pregnancy and Breast Feeding. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2013;16(60):18-24.
36. WHO Guidelines Approved by the Guidelines Review Committee. Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide for Essential Practice. Geneva: World Health Organization
Copyright © World Health Organization 2015.; 2015.
37. Oakley SH, Walther-Liu J, Crisp CC, Pauls RN. Acupuncture in Premenopausal Women With Hypoactive Sexual Desire Disorder: A Prospective Cohort Pilot Study. Sex Med. 2016;4(3):e176-81.
38. Fakhri A., Mohammadi Zeidi I., Pakpour Haji Agha A., Morshedi H., Mohammad Jafari R., Ghalambor Dezfooli F. Psychometric Properties of Iranian Version of Female Sexual Function Index. JSMJ. 2011;10(4):345-354.
39. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191-208.
40. Mohammadi Khadijeh, Heydari Masoumeh, Faghihzadeh Socrates. The validity of the Persian version of the Female Sexual Function Index-FSFI as a Sexual Function Index of Women.PAYESH.2008;7(3):269-78.
41. Khosravi Anbaran Z, Baghdari N, Pourshirazi M, Karimi FZ, Rezvanifard M, Mazlom SR. Postpartum sexual function in women and infant feeding methods. J Pak Med Assoc. 2015;65(3):248-52.
42. Martins EL, Vargens OMC. Perceptions of women about sexuality during breastfeeding: an integrative literature review. Rev. enferm. UERJ. 2014:271-7.
43. O'Malley D, Higgins A, Begley C, Daly D, Smith V. Prevalence of and risk factors associated with sexual health issues in primiparous women at 6 and 12 months postpartum; a longitudinal prospective cohort study (the MAMMI study). BMC Pregnancy Childbirth. 2018;18(1):196.
44. Song M, Ishii H, Toda M, Tomimatsu T, Katsuyama H, Nakamura T, et al. Association between sexual health and delivery mode. Sex Med. 2014;2(4):153-8.
45. Lurie S, Aizenberg M, Sulema V, Boaz M, Kovo M, Golan A, et al. Sexual function after childbirth by the mode of delivery: a prospective study. Arch Gynecol Obstet. 2013;288(4):785-92.
46. Malakoti J, Zamanzadeh V, Maleki A, Farshbaf Khalili A. Sexual function in breastfeeding women in family health centers of tabriz, iran, 2012. J Caring Sci. 2013;2(2):141-6.
47. Yee LM, Kaimal AJ, Nakagawa S, Houston K, Kuppermann M. Predictors of postpartum sexual activity and function in a diverse population of women. J Midwifery Womens Health. 2013;58(6):654-61.
48. Matthies LM, Wallwiener M, Sohn C, Reck C, Müller M, Wallwiener S. The influence of partnership quality and breastfeeding on postpartum female sexual function. Arch Gynecol Obstet. 2019;299(1):69-77.
49. Zare Z, Golmakani N, Khadem N, Shareh H. The effect of pelvic floor muscle exercises on sexual quality of life and marital satisfaction in primiparous women after childbirth. Iran J Obstet Gynecol Infertil. 2014;17(103):21-32.
50. Kwan WS, Li WW. Effect of ear acupressure on acute postpartum perineal pain: a randomised controlled study. J Clin Nurs. 2014;23(7-8):1153-64.
51. Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Womens Health (Lond). 2019;15:1745506519844044.
52. Rastegarzade H, Abedi P, Valiani M. The effect of auriculotherapy on labor pain intensity in nulliparous women. Anesthesiology and Pain. 2015;6(3):54-63.
53. Khamba B, Aucoin M, Lytle M, Vermani M, Maldonado A, Iorio C, et al. Efficacy of acupuncture treatment of sexual dysfunction secondary to antidepressants. J Altern Complement Med. 2013;19(11):862-9.
54. Li WS, Cui SS, Li WY, Zhao WX, Wanlai SQ. [Effects of magnetic auricular point-sticking on adjuvant anesthesia and postoperative recovery of body function]. Zhongguo Zhen Jiu. 2011;31(4):349-52.
55. Saffari M, Khashavi Z, Valiani M. The Effect of Auriculotherapy on the Stress and the Outcomes of Assistant Reproductive Technologies in Infertile Women. Iran J Nurs Midwifery Res. 2018;23(1):8-13.
56. Qu F, Zhang D, Chen LT, Wang FF, Pan JX, Zhu YM, et al. Auricular acupressure reduces anxiety levels and improves outcomes of in vitro fertilization: a prospective, randomized and controlled study. Sci Rep. 2014;4:5028.
57. Jouya S, Golmakani N, Mazloum SR, Abdi H, Yousefi Z. Effect of auriculotherapy with vaccaria seeds on the anxiety of female colposcopy Candidates. Iran J Obstet Gynecol Infertil. 2018;21(1):70-9.
58. Zenouzi A, Asghari M. A review of women's sexual dysfunction during postpartum. JSSU. 2018;25(12):940-50
59. do Prado JM, Kurebayashi LF, da Silva MJ. [Auriculotherapy effectiveness in the reduction of anxiety in nursing students]. Rev Esc Enferm USP. 2012;46(5):1200-6.
60. Kurebayashi LF, Silva MJ. Efficacy of Chinese auriculotherapy for stress in nursing staff: a randomized clinical trial. Rev Lat Am Enfermagem. 2014;22(3):371-8.
61. Kurebayashi LF, Turrini RN, Souza TP, Marques CF, Rodrigues RT, Charlesworth K. Auriculotherapy to reduce anxiety and pain in nursing professionals: a randomized clinical trial. Rev Lat Am Enfermagem. 2017;25:e2843.
62. Ko YL, Lin SC, Lin PC. Effect of auricular acupressure for postpartum insomnia: an uncontrolled clinical trial. J Clin Nurs. 2016;25(3-4):332-9.
IssueVol 17 No 3 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijps.v17i3.9726
Auriculotherapy Breast Feeding Sexual Activity Women

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Rashidi Ahmad Abadi M, Valiani M, Kabir K, Khalajinia Z, Yazdkhasti M. The Effectiveness of Auriculotherapy on Women’s Sexual Function: A Randomized Controlled Trial. Iran J Psychiatry. 2022;17(3):265-275.