Methods: This randomized controlled clinical trial included 24 women with secondary anorgasmia referring to health centers in Tehran, Iran. After randomly assigning the participants to one of two groups of intervention (n=12) and control (n=12), an eight-session CBGT with the emphasis on sexual assertiveness training was administered to the intervention group. The primary outcomes were sexual assertiveness and the orgasm score of the participant. Sexual desire, sexual arousal, lubrication, sexual satisfaction, and pain were considered as secondary outcomes. Finally, the female sexual function index (FSFI) and the Hurlbert index of sexual assertiveness questionnaires were used for data gathering.

Results: After CBGT implementation, there was a significant difference between the intervention (5.33±0.62) and control (2.47±0.76) groups in the mean score of orgasm (P < 0.001). In addition, the mean score of sexual assertiveness (P < 0.001) and all other domains of FSFI (P < 0.001) significantly increased after CBGT.

Conclusions: Sexual assertiveness-focused CBGT was effective in the treatment of secondary anorgasmia and increased their sexual function. To prevent marital conflicts, establishing counseling clinics in health centers can be established by authorities in order to correct ineffective sexual beliefs and self-assertiveness in the country.