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381), but it was significantly higher in the intervention group than control group after intervention (the adjusted MD 4.24, 95% confidence interval [CI] 3.18-5.29, 0.001). There was no statistically significant difference between the two groups in marital satisfaction before the intervention ( = 0.433), but it increased significantly in the intervention group in comparison to control after intervention (adjusted MD 23.17, 95% CI 15.10-31.24, 0.001). The study findings suggested that sexual counseling based on the Ex-PLISSIT