女性围绝经期性激素水平与性欲障碍的关系和雌激素替代疗法干预的作用及意义

The relationship between female perimenopausal sex hormone levels and libido disorder and the effect and significance of estrogen replacement therapy intervention

目的探究女性围绝经期性激素水平与性欲障碍的关系,并分析雌激素替代疗法干预的作用与意义。方法选取2018年3月至2021年3月海南现代妇女儿童医院就诊的103例围绝经期女性作为研究对象,根据女性性功能指数(FSFI)问卷调查结果分为性欲正常组(n=22)与性欲障碍组(n=81)。比较两组性欲评分、绝经指数、性激素[雌二醇(E_(2))、卵泡生成素(FSH)、孕酮(P)、睾酮(T)]水平,分析性激素水平与性欲评分、绝经指数的相关性及对性欲障碍的预测价值;性欲障碍组均给予雌激素替代疗法干预,对比不同干预效果患者性激素变化。结果性欲障碍组性欲评分、E_(2)、P、T水平低于性欲正常组,绝经指数、FSH高于性欲正常组(P<0.05);E_(2)、P、T水平与性欲评分呈正相关,与绝经指数呈负相关,FSH与性欲评分呈负相关,与绝经指数呈正相关(P<0.05);受试者工作特征(ROC)曲线显示,E_(2)、P、T、FSH联合预测性欲障碍的曲线下面积(AUC)为0.920,高于各指标单独预测。性欲障碍组经雌激素替代疗法干预3个月后总有效率为80.25%;性欲障碍组显效患者入院时、干预3个月后E_(2)、P、T水平高于有效患者、无效患者,有效患者高于无效患者;性欲障碍组显效患者入院时、干预3个月后FSH低于有效患者、无效患者,有效患者低于无效患者(P<0.05)。结论E_(2)、T、P、FSH等性激素水平可从机体内分泌层面有效预测围绝经期女性性欲障碍,雌激素替代疗法能通过调节性激素水平改善性欲障碍。

Objective To explore the relationship between female perimenopausal sex hormone levels and libido disorder,and to analyze the effect and significance of estrogen replacement therapy intervention.Methods A total of 103 perimenopausal women who visited Hainan Modern Women and Children′s Hospital from March 2018 to March 2021 were selected as the research objects.According to the results of female sexual function index(FSFI)questionnaire,they were divided into libido normal group(n=22)and libido disorder group(n=81).The libido score,menopausal index,and sex hormones[estradiol(E_(2)),follicular stimulating hormone(FSH),progesterone(P),and testosterone(T)]were compared between the two groups.The correlation between sex hormone level and sexual desire score,menopausal index and the predictive value of libido disorder were analyzed.The sex hormone changes of patients with different intervention effects were compared.Results The libido score,E_(2),P,and T levels were lower in the libido disorder group than in the libido normal group,and the menopausal index and FSH were higher than in the libido normal group(P<0.05);E_(2),P,and T levels were positively correlated with libido score and negatively correlated with menopausal index,and FSH was negatively correlated with libido score and positively correlated with menopausal index(P<0.05);the receiver operating characteristic(ROC)curve showed that E_(2),P,T,and FSH jointly predicted libido disorders with an area under the curve(AUC)of 0.920,which was higher than that predicted by each index alone.The total effective rate of the libido disorder group after 3 months of estrogen replacement therapy intervention was 80.25%;E_(2),P,and T levels were higher in the libido disorder group at the time of admission and after 3 months of intervention than in the effective and ineffective patients,and in the effective patients than in the ineffective patients;FSH was lower in the libido disorder group at the time of admission and after 3 months of intervention than in the effective and ineffective patients,and in the effective patients than in the ineffective patients(P<0.05).Conclusions E_(2),T,P,FSH and other sex hormone levels can effectively predict libido disorders in perimenopausal women from the endocrine level of the body,and estrogen replacement therapy can improve libido disorders by regulating sex hormone levels.