OBJECTIVE: This study evaluated the effectiveness of a culturally adapted Sexual Health Enhancement (SHE) program, grounded in the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model, in addressing sexual health challenges in women with breast cancer. It examined the program's impacts on sexual function, distress, body image, marital intimacy, and sexual knowledge. METHODS: A quasi-experimental pretest-posttest design included 50 married women diagnosed with breast cancer within five years post-mastectomy without reconstruction. Participants were divided into intervention (n = 24) and control (n = 26) groups. The intervention consisted of four weekly group sessions and phone consultations. Outcomes were assessed at baseline, one week, and five weeks posttest using validated tools. RESULTS: The intervention group showed significant improvements in sexual distress (F = 24.852, p <
0.001), body image (F = 25.887, p <
0.001), and sexual knowledge (F = 60.876, p <
0.001). Marital intimacy improved over time (F = 7.050, p = 0.011), but no significant group-by-time interaction was found (F = 0.478, p = 0.493). Sexual function showed no significant differences (F = 0.748, p = 0.391). CONCLUSIONS: The SHE program effectively improved sexual distress, body image, and knowledge in breast cancer survivors. Tailored interventions for body image and marital intimacy remain essential, and future research should explore digital solutions and spousal involvement to enhance outcomes.