口服避孕药对多囊卵巢综合征患者性功能的影响

Effects of oral contraceptives on sexual function in PCOS patients

目的评估口服避孕药(oral contraceptives,OCs)对多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者性功能的影响,并分析其女性性功能障碍(female sexual dysfunction,FSD)发生的危险因素。方法研究共纳入210例门诊PCOS患者,其中服用口服避孕药者126例(OC组),未服用者84例(NOC组)。采用网络女性性功能指数(Female Sexual Function Index,FSFI)量表,并补充附加问题,评估参与者的基本信息、避孕方法、性伴侣关系稳定程度、孕产史等多个女性性功能的潜在影响因素。结果OC组FSFI总分中位数为26.35分,50.79%表现为FSD高风险;NOC组FSFI总分中位数26.85分,47.62%显示FSD高风险;两组得分相比差异无统计学意义(P=0.635)。在口服避孕药使用者中,服用35μg炔雌醇/2 mg醋酸环丙孕酮、30μg炔雌醇/3mg屈螺酮、30μg炔雌醇/150μg去氧孕烯三种不同成分口服避孕药的患者之间,FSFI得分差异无统计学意义。经Logistic回归分析,性生活是否主动、伴侣关系是否稳定是PCOS患者性功能的影响因素。结论 PCOS患者中,是否服用口服避孕药、服用不同类型口服避孕药的患者之间性功能评分差异均无统计学意义。PCOS患者性功能的潜在影响因素中,性生活是否主动、伴侣关系是否稳定与FSD高风险的发生相关。

Objective To investigate the effects of oral contraceptives on sexual function in polycystic ovary syndrome（PCOS）patients. Methods The online questionnaire was completed by PCOS patients in clinic. PCOS patients in the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University were enrolled. They were divided into two groups taking oral contraceptives（OC group） not taking OC（NOC group）. The primary endpoint was the Female Sexual Function Index（FSFI） score,with additional questions on contraception,sexual activity,relationship stability,pregnancy and other factors which may influence sexual function. Results Totally 210 PCOS patients were recruited in this study to participate in the survey using the online questionnaire. Of all women participating,126 were taking oral contraceptives（OC group） and 84 were not taking OC（NOC group）. Among OC users,the median FSFI total score was 26. 35,and 50. 79% showed high risk of female sexual dysfunction（FSD）. Regarding NOC group,the median FSFI total score was 26. 85,47. 62% showed high risk of FSD. There was no significant difference between two groups（P = 0. 635）. Also,no differences of FSFI scores were seen in patients taking 35 μg ethinyl estradiol（EE）/2 mg cyproterone acetate（CPA）,30 μg EE/3 mg drospirenone（DRSP）,and 30 μg EE/150 μg desogestrel. Relationship stability and sexual activity were found to be associated with sexual function in PCOS patients. Conclusion There was no significant difference between OC users and not taking OC users in PCOS patients. Different progestins in OCs and the EE dosage in OCs have nosignificant influence on sexual function in PCOS patients. Regarding PCOS patients,sexual activity and relationship stability may be risk factors of FSD.