Effects of Model-Based Sexual Counseling on Sexual Function and Sexual Life in Women with Breast Cancer: A Systematic Review and Meta-Analysis

Background/Objectives: Sexual dysfunction is a common and persistent concern among women with breast cancer. Although various interventions have been developed to address sexual health, evidence regarding counseling interventions structured around theoretical models remains limited. This systematic review and meta-analysis aimed to evaluate the effects of model-based sexual counseling on overall sexual life and sexual function in women with breast cancer. Methods: The review was conducted in accordance with the Cochrane Handbook and PRISMA guidelines and was prospectively registered in PROSPERO (CRD420251004532). Five electronic databases were searched for controlled intervention studies published up to February 2025. Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 1) for randomized controlled trials and ROBINS-I for nonrandomized studies. Random-effects meta-analyses were performed using Comprehensive Meta-Analysis version 3, with effect sizes expressed as Hedges’ g and 95% confidence intervals (CIs). Results: Ten controlled intervention studies involving 779 participants were included, comprising seven randomized controlled trials and three nonrandomized controlled intervention studies. Model-based counseling was associated with statistically significant pooled effects on overall sexual life (g = 1.86, 95% CI 0.94–2.77; p < 0.001; I2 = 95.93%) and sexual function (g = 2.11, 95% CI 0.94–3.28; p < 0.001; I2 = 97.08%). PLISSIT-based counseling showed no statistically significant pooled effects. Time-based analyses showed the largest effects at 6–8 weeks, with statistically significant effects persisting at 12 weeks. Substantial heterogeneity was observed across analyses. Conclusions: Model-based sexual counseling may have beneficial effects on overall sexual life and sexual function in women with breast cancer; however, the very low certainty of evidence and substantial heterogeneity limit confidence in these findings. Further well-designed randomized controlled trials using standardized interventions and longer follow-up are needed.