围绝经期与绝经后女性雄激素浓度对情绪障碍及性功能障碍的影响

The effect of androgen levels on mood disorders and sexual dysfunction in peri-and postmenopausal Chinese women

目的探讨围绝经期与绝经后女性雄激素浓度对情绪障碍及性功能障碍的影响。方法募集2022年1月至2022年12月于首都医科大学附属北京妇产医院内分泌科就诊的280例40~65岁女性,包括绝经前76例、围绝经期84例和绝经后120例,测量身高、体质量、血压、腰围、臀围等指标,进行包括情绪障碍和性功能障碍等绝经相关症状的问卷调查。将围绝经期及绝经后女性分为情绪障碍组及对照组,性功能障碍组及对照组,采用化学发光免疫法检测血清卵泡刺激素、黄体生成素、雌二醇、孕酮、催乳素浓度,采用液相色谱串联质谱法检测血清性激素结合球蛋白、总睾酮、游离睾酮、生物活性睾酮、脱氢表雄酮、硫酸脱氢表雄酮、雄烯二酮、双氢睾酮浓度。结果与绝经前相比,围绝经期与绝经后女性的血清游离睾酮、生物活性睾酮、雄烯二酮、脱氢表雄酮、硫酸脱氢表雄酮浓度显著降低(P<0.05),但这些激素浓度在围绝经期与绝经后女性中差异无统计学意义(P>0.05);与绝经前相比,围绝经期与绝经后女性血清总睾酮浓度稍降低,但差异无统计学意义(P>0.05);围绝经期与绝经后女性情绪障碍与血清总睾酮浓度降低有关(P<0.05),性功能障碍与血清硫酸脱氢表雄酮浓度降低有关(P<0.05)。结论围绝经期与绝经后女性多种雄激素浓度下降,情绪障碍与血清总睾酮浓度降低有关,性功能障碍与血清硫酸脱氢表雄酮浓度降低有关。

Objective To study the effect of peri-and postmenopausal androgen levels on mood disorders and female sexual dysfunction(FSD).Methods From Jan.2022 to Dec.2022,a total of 280 women aged 40-65 years who attended the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University were recruited and divided into 76 premenopausal,84 perimenopausal and 120 postmenopausal women.Height,weight,blood pressure,waist circumference,and hip circumference were measured.Questionnaires on menopause-related symptoms including mood disorders and sexual dysfunction were administered.The peri-and postmenopausal women were divided into emotional disorders group and control group,sexual dysfunction group and control group.The levels of serum follicle stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E_(2))were measured with chemiluminescence immunoassay,and the levels of serum sex hormone binding globulin(SHBG),total testosterone(TT),free testosterone(FT),bioactive testosterone(BT),dehydroepiandrosterone(DHEA),dehydroepiandrosterone sulfate(DHEA-S),androstenedione(A2),and dihydrotestosterone(DHT)were tested with liquid chromatography-tandem mass spectrometry(LC-MS/MS).Results Compared with premenopausal women,the serum levels of FT,BT,A2,DHEA,and DHEA-S were significantly lower in peri-and postmenopausal women(P<0.05),but not significantly different between peri-and postmenopausal women(P>0.05).The serum TT levels were slightly lower in peri-and postmenopausal women,but the difference was not significant(P>0.05).The serum TT levels were negatively correlated with mood disorders(P<0.05)and serum DHEA-S levels were negatively correlated with sexual dysfunction(P<0.05).Conclusions Multiple androgen levels declined in peri-and postmenopausal women,mood disorders were negatively correlated with serum TT levels,and FSD was negatively correlated with serum DHEA-S levels.