Background: After developing breast cancer, women experience changes in their sexuality, femininity, and fertility. These changes lead to poor mental health and increased psychological stress. Therefore, this study aimed to investigate the effects of Good Enough Sex (GES)-based, couple-centered group counseling on reproductive and sexual concerns of breast cancer survivors.Methods: This was a quantitative randomized controlled clinical trial (RCT). After completing the informed consent forms, 100 women were assigned to the intervention and control groups (50 individuals per group) using randomized block design. The intervention included four 90-120-minute sexual counseling sessions with 2 and 3-month follow-ups. The data were collected using the socio-demographic and clinical characteristics, Persian version of Depression, Anxiety and Stress Scale (DASS-21), Reproductive Concerns After Cancer (RCAC) scale, and Female Sexual Function Index adaptation for Breast Cancer patients (FSFI-BC). The obtained data were analyzed in SPSS 20 using descriptive and repeated measures analysis of variance (ANOVA) test.Results: Significant differences were observed between the intervention and control groups in terms of the mean stress, anxiety, depression, reproductive concerns, and sexual function scores of the participants (P < 0.001). Therefore, the GES-based, couple-centered group counseling is associated with significant reductions in reproductive and sexual concerns of female breast cancer survivors.Conclusions: The designed psychosocial training and counseling intervention effectively reduced reproductive and sexual concerns of female breast cancer survivors. Therefore, these training and counseling programs can be organized by relevant service centers to promote the reproductive health of women with breast cancer.