Strengths and limitations
Designing the study based on clinical trials principles, such as random allocation and allocation concealment to eliminate the selection bias in addition to having no attrition rate were among the strengths of this study. There are some limitations in this research, including self-reporting of data, impossibility of blinding the participants due to the nature of the study, lack of long-term follow-up, and failure to investigate the spouses, due to the taboo of sexual issues in Iran and their unwillingness to participate in the study. Moreover, the baseline mean score of sexual assertiveness and satisfaction was very close to the cut-off limit in all groups. The findings may be different, if the studied population had lower baseline assertiveness and satisfaction. Therefore, it is suggested to perform further studies in other population.