CHANGES IN SEXUAL DISTRESS AMONG WOMEN WITH GYNECOLOGICAL CONDITIONS USING THE ODEYA APP-BASED INTERVENTION: A MIXED-METHODS STUDY

Sexual dysfunction with distress (SD) affects 17.5% of women annually. Women with gynecologic conditions are particularly at risk. While sex therapy can improve sexual function and reduce distress, limited reimbursement and access to specialists remain important barriers in the healthcare system. Digital solutions such as the Odeya app offer scalable, personalized care for sexual distress. This feasibility study evaluates exploratory symptom change in sexual health outcomes in women with SD and endometriosis.

Sixty participants are randomized to an intervention group (IG, n = 30) or control group (CG, n = 30). Inclusion criteria include a (suspected) diagnosis of endometriosis and sexual distress scores (FSDS-DAO > 18). Exclusion criteria include suicidality, severe depression, anxiety disorder, PTSD, substance dependence, psychosis, or pregnancy. The IG will receive a 12-week digital intervention with eight self-guided modules on pain, anatomy, and communication, while the CG will receive standard care. Both groups will complete validated questionnaires assessing sexual health (e.g., sexual distress (FSDS-DAO), function (FSFI-d), sexual self-esteem (SSEI-d)), partnership satisfaction (PFB), pain and urogenital symptoms (CSI-GE, ICIQ-FLUTS), mental health (BDI-II, GAD-7, BSI, PSS-10), and quality of life (PROMIS-29, EUROHIS-QOL) at module 5, module 8, and 3 months post-intervention. Using a mixed methods approach, qualitative assessment will also be conducted in post-intervention focus group discussions to provide qualitative insights into symptom changes.

Of 104 individuals screened, 77 have completed the process, with 35 enrolled to date. Preliminary data indicate that most participants have no prior sex therapy experience, are in relationships (IG: 94.4%, CG: 83.3%), and have high baseline sexual distress (FSDS-DAO, mean (SD), IG: 35.6 (11.2), CG: 35.4 (9.1)). Group comparisons will use two-sided t-tests, with continuous outcomes analyzed by ANCOVA on an intention-to-treat basis. Post-hoc analyses will identify subgroups that benefit most from distress reduction. Qualitative data will be analyzed using inductive thematic analysis.

This study will provide insight into the feasibility of an app-based sex therapy intervention tailored to patient needs and exploratory changes in sexual health outcomes. If efficacy can be demonstrated, this intervention could provide a scalable solution for women with SD in Germany.

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