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...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。展开更多
Abstract Objective To investigate the female sexual dysfunction （FSD） in type 2 diabetes patients, by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function In...Abstract Objective To investigate the female sexual dysfunction （FSD） in type 2 diabetes patients, by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function Index （FSFI）. Methods 215 type 2 diabetic women and 107 age-matched non-diabetes women were enrolled with similar backgrounds. Their sexual functions were evaluated with FSFI. Metabolic parameters such as body mass index, blood lipid profile, hemoglobin AlC, plasma glucose were also collected. Results Total score of FSFI of the type 2 diabetic women were significantly lower than that of the non-diabetic controls （18.27±8.96 vs. 23.02±5.78, P=0.000）. Scores of the FSFI domains （desire, arousal, lubrication, orgasm, satisfaction, pain） of the type 2 diabetic group were also lower than those of the control group. According to the FSD criterion （FSFI〈25） available in China, the percentage of FSD in the type 2 diabetic group was significantly higher than that of the control group （79.2% vs. 55.0%, P〈0.001）. These trends seemed more prominent in pre-menopause subgroups. The logistic regression analysis indicated that age and diabetes were independent risk factors of FSD. Body Mass Index （BMI） also had influence in the diabetes group. Conclusion Findings from this study showed that there are more FDS in Chinese type 2 diabetic women than in their non-diabetic counterparts, especially in pre-menopause participants.展开更多
The concept of structure-soil-structure dynamic interaction was introduced and the research methods were summarized.Based on lots of documents,a systematic summary of the history and current situation of structure-soi...The concept of structure-soil-structure dynamic interaction was introduced and the research methods were summarized.Based on lots of documents,a systematic summary of the history and current situation of structure-soil-structure dynamic interaction research considering adjacent structures was proposed as reference for researchers.The existing matter and the prospect of future research trend in this field was also examined.展开更多
Sexual satisfaction following Laser or RF vaginal rejuvenation is usually assessed by straightforward self-report questionnaires that may not offer a deeper insight into female dynamics. Our randomized double-blind lo...Sexual satisfaction following Laser or RF vaginal rejuvenation is usually assessed by straightforward self-report questionnaires that may not offer a deeper insight into female dynamics. Our randomized double-blind longitudinal clinical trial on 14 menopausal women with high FSFI satisfaction scores following laser or RF vaginal interventions, demonstrated a high positive correlation between the subjects’ FSFI scores and the Hy (hysteria), D (Depression) and L (Lie) validity scales of the MMPI-2. Such high positive correlation between the FSFI and the L-scale negates the reported increase in female sexual satisfaction following laser or RF vaginal rejuvenations. The high positive correlations of the FSFI with the Hy and D scales indicate that despite reports of increased sexual satisfaction, the vaginal procedures did not improve psychological wellbeing or quality of life. Results on the Differential Emotions Scale (DES) reveal that 98% of the subjects were organized around the emotions of shame, sadness and joy. Such results indicated a multilayered emotional organization that possibly reflects joy on the outside and shame and sadness on the inside. Results of Laser or RF vaginal rejuvenation procedures should be evaluated by a battery of tests that take into account females’ often prominent tendency to focus on satisfying their partners rather than themselves. Going down the path that starts with a dismissal of self-fulfillment to focus on their partners’ satisfaction, may bring several women to the endpoint of disingenuous interpersonal relationships tainted by repressed disillusionment.展开更多
Introduction: Urinary incontinence is a common problem that can affect the quality of life of women of all ages and can negatively influence the exercise of sexuality. Aim: The aim of this study was to compare sexual ...Introduction: Urinary incontinence is a common problem that can affect the quality of life of women of all ages and can negatively influence the exercise of sexuality. Aim: The aim of this study was to compare sexual function of women before and after surgical treatment for urinary incontinence. Method: The sample consisted of 38 women with urinary incontinence and surgical treatment (Burch or Sling procedure). The Female Sexual Function Index (FSFI) was used to evaluate sexual dysfunction before and after surgical treatment. Results: The mean age of the women in the study was 48 ± 8.8 years, and 58% were 50 years old or younger. By analyzing FSFI, it was observed that the majority of subjects had an overall index of sexual dysfunction (score < 26 points) before surgery. The desire and arousal domains improved significantly after surgery for all women included in the study. It was also observed that women with higher levels of education had more positive results related to desire. Conclusions: In our sample, in general, sexual function improved after surgical treatment of urinary incontinence, regardless of technique used, particularly in the discounter and pain domain. There was a substantial improvement of the sexual function among women who had presented with cystocele. Desire and arousal improved significantly after surgery, very likely due to the improvement of self-esteem after surgery.展开更多
<b>Introduction:</b> Female sexual dysfunction (FSD) is a serious problem that affects negatively the quality of life, interpersonal relationships and female self- confidence and might be a direct cause of...<b>Introduction:</b> Female sexual dysfunction (FSD) is a serious problem that affects negatively the quality of life, interpersonal relationships and female self- confidence and might be a direct cause of psychopathological disturbances. Female pattern hair loss (FPHL) is a common cosmetically disturbing condition affecting many women with social and psychological consequences. <b>Aim of the Work:</b> Assessment of the relationship between female sexual dysfunction and Female pattern hair loss in premenopausal females.<b> Methods:</b> A case-control study was carried on 47 female patients with FPHL and 43 age- matched control women without FPHL among premenopausal women attending dermatology and Andrology outpatient’s clinics, Suez Canal University hospital during the period from May 2018 to January 2019. History taking, clinical examination and hormonal investigation (Free Testosterone, Total Testosterone, and SHBG) were performed to all participants in the study. <b>Main Outcome Measures:</b> The Female Sexual Function Index (FSFI) was used to assess the key aspects of female sexual function in patients and controls. FPHL was diagnosed and graded by Ludwig’s classification. <b>Results:</b> Mean age of patients group was 30.12 ± 5.49 years, Regarding FPHL grading, 55.3%, 42.6% & 2.1% of patients were grades 1, 2 and 3 Ludwig’s classification respectively. FSD was found in 44.7% of patients while it was 44.2% in control group (P > 0.05). FSFI score in patients group was 26.40 ± 4.61 and in control group was 27.05 ± 3.12 (P > 0.05). Correlation between FSD prevalence and grade of FPHL by Ludwig’s classification was statistically insignificant. FSD was significantly compromised by increasing age and parity in patients and control groups (P < 0.05). <b>Conclusions:</b> The present study suggests that FSD was not significantly related to FPHL. Increased age and parity may have strong impact on sexual function in premenopausal women, while androgen hormones levels were not determinant factor.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Rheumatoid arthritis i...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Rheumatoid arthritis is a chronic autoimmune disease that causes socio-economic, psychological and sexual problems. It imposes limitations on sexual relationships and these issues are still taboo in African society. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> T</span></span><span style="font-family:Verdana;">he </span><span style="font-family:Verdana;">o</span><span style="font-family:Verdana;">bjective is to</span><span style="font-family:""><span style="font-family:Verdana;"> assess the impact of rheumatoid arthritis (RA) on women’s sexuality at the Ignace Deen National Hospital. </span><b><span style="font-family:Verdana;">Patients</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was an analytic case-control study of 8 months (from April 6, 2020 to December 11, 2020). All patients followed for rheumatoid arthritis diagnosed according to 2010 ACR/EULAR criteria for RA had been included. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> One hundred and five women (52 RA patients and 53 controls) were collected. The two groups were comparable in terms of demographic characteristics. Sexual dysfunction was found in 69.2% of cases versus 35.8% of controls. Women with RA had poorer sexual functioning in the categories of desire, arousal, lubrication, orgasm, satisfaction, and pain of the FSFI score compared to healthy women (p = 0.01;p = 0.7;p = 0.3;p = 0.8;p = 0.1;and p = 0.3 respectively). Patients were 4 times more likely to have sexual dysfunction than healthy individuals and this result was statistically significant with a p-value less than 0.05. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Sexual dysfunction was noted in a large number of RA patients surveyed at the rheumatology department of the Ignace Deen national hospital. A larger study is needed to better assess this issue and seek management solutions.展开更多
Background: Sexual dysfunction is sexual complaints or disorders. There are various causes, but the onset leads to deterioration of relationships and quality of life with partners. There is still a deep-rooted awarene...Background: Sexual dysfunction is sexual complaints or disorders. There are various causes, but the onset leads to deterioration of relationships and quality of life with partners. There is still a deep-rooted awareness that sexuality is a secret in Japan. Aim: This study aims to clarify the relationship between female sexual function and depression or anxiety. Method: Four hundred and fifty-eight Japanese healthy women who worked in four randomly selected medical institutions in Okinawa Prefecture in Japan from March to May 2012 were asked to agree to a consent form of their own free will and participate in self-reported questionnaires. For their evaluation, the Female Sexual Function Index (FSFI;Rosen et al. 2000, which includes the six domains of desire, arousal, lubrication, orgasm, pain, and satisfaction) and the Kessler Psychological Distress Scale (K6;Kessler, 2002, which includes the following six items: felt nervous, hopeless, restless or fidgety, worthless, depressed, and felt that everything was an effort) was used. Moreover, participants’ characteristics showed age, marriage, menopause, annual income, and drinking. In addition, JMP16.2 and R 4.2.0 was used to perform Pearson’s chi-square test, Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, Steel-Dwass test, Spearman’s Rank-Order Correlation, and Cronbach’s alpha. This study was approved by the university and the medical institutional review board (IRB). Results: 178 women were included in the final analysis, and the median (IQR, interquartile range) was 39 (32 - 48) years old, and the mean ± SD (standard deviation) was 40.2 ± 10.4 years old. The median (IQR) and mean ± SD of FSFI Total Score were 22.0 (9.3 - 26.6) and 19.2 ± 9.6. The median (IQR) and the mean ± SD of K6 Total Score were 3 (0 - 7) and 4.2 ± 4.5. 16% of all women with a K6 Total Score of 10 and more, and 5% of all women with a K6 Total Score of 13 and more considered a serious mental illness. There was no clear association between female sexual function and depression or anxiety in all health worker participants between FSFI Total Score and K6 Total Score by Spearman’s Rank-Order Correlation Coefficient (ρ). However, there was a moderate correlation between the K6 Total Score and the FSFI Total Score in health worker participants with a K6 Total Score of 11 or more (n =19, ρ = ?0.62, P = 0.005). Moreover, there was a weak correlation between them in both married and drinking women or married and non-menopausal women. In the Mann-Whitney U test where few participants had morbid depression, significant relationships were found in the association between a sexual function with high depression or anxiety, whereas the low group had a K6 cut-off value of 11. Conclusion: Female sexual morbidity for high depression or anxiety should be managed with interventions. Especially, the intervention for decreasing female sexual function in the K6 Total Score of 11 or more will be needed, and a randomized study is required for more evidence.展开更多
目的研究女性性功能障碍(female sexual dysfunction,FSD)的影响因素,为围绝经期和绝经后女性生活质量的改善方法提供临床依据。方法纳入2020年4月至2021年3月在首都医科大学附属北京妇产医院及两家医联体医疗机构就诊的女性902例。收...目的研究女性性功能障碍(female sexual dysfunction,FSD)的影响因素,为围绝经期和绝经后女性生活质量的改善方法提供临床依据。方法纳入2020年4月至2021年3月在首都医科大学附属北京妇产医院及两家医联体医疗机构就诊的女性902例。收集社会人口学资料、生物学、临床特征和躯体测量指标。根据女性性功能指数(Female Sexual Function Index,FSFI)量表评估FSD将研究对象分为2组:有FSD和无FSD。根据“生殖衰老研讨会分期+10”将研究对象分期、改良Kupperman评分表(Modified Kupperman Index,KMI)评估更年期症状、心理健康问卷-9量表评价抑郁状态、国际尿失禁咨询委员会尿失禁问卷(International Consultation on Incontinent Questionnaire,ICIQ)量表评估女性压力性尿失禁、膀胱过度活动症评分(Overactive Bladder Symptom Score,OABSS)量表评估膀胱过度活动症。FSD的影响因素应用二元Logistic回归多因素分析。结果多因素分析结果显示:KMI评分(OR=1.061,95%CI:1.039~1.083)、血清卵泡刺激素(follicle stimulating hormone,FSH)(OR=1.008,95%CI:1.002~1.014)、高中以下学历(OR=1.446,95%CI:1.019~2.052)、抑郁(OR=1.814,95%CI:1.156~2.845)、绝经后早期(OR=1.717,95%CI:1.106~2.667)、绝经后晚期(OR=1.905,95%CI:1.008~3.602)、婚姻关系一般(OR=2.422,95%CI:1.711~3.429)和婚姻关系不满意(OR=1.945,95%CI:1.018~3.717)是FSD的重要危险因素(P<0.05);绝经后早期应用芬吗通治疗是FSD的重要保护因素(OR=0.229,95%CI:0.059~0.889,P<0.05)。结论FSD受心理、生理、社会等多种因素的影响,卵巢衰竭是FSD的重要危险因素,绝经后女性早期应用绝经激素治疗是FSD的保护因素。展开更多
文摘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。
基金supported by the Research Fund from Zhejiang Health Department,2009A119
文摘Abstract Objective To investigate the female sexual dysfunction （FSD） in type 2 diabetes patients, by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function Index （FSFI）. Methods 215 type 2 diabetic women and 107 age-matched non-diabetes women were enrolled with similar backgrounds. Their sexual functions were evaluated with FSFI. Metabolic parameters such as body mass index, blood lipid profile, hemoglobin AlC, plasma glucose were also collected. Results Total score of FSFI of the type 2 diabetic women were significantly lower than that of the non-diabetic controls （18.27±8.96 vs. 23.02±5.78, P=0.000）. Scores of the FSFI domains （desire, arousal, lubrication, orgasm, satisfaction, pain） of the type 2 diabetic group were also lower than those of the control group. According to the FSD criterion （FSFI〈25） available in China, the percentage of FSD in the type 2 diabetic group was significantly higher than that of the control group （79.2% vs. 55.0%, P〈0.001）. These trends seemed more prominent in pre-menopause subgroups. The logistic regression analysis indicated that age and diabetes were independent risk factors of FSD. Body Mass Index （BMI） also had influence in the diabetes group. Conclusion Findings from this study showed that there are more FDS in Chinese type 2 diabetic women than in their non-diabetic counterparts, especially in pre-menopause participants.
文摘The concept of structure-soil-structure dynamic interaction was introduced and the research methods were summarized.Based on lots of documents,a systematic summary of the history and current situation of structure-soil-structure dynamic interaction research considering adjacent structures was proposed as reference for researchers.The existing matter and the prospect of future research trend in this field was also examined.
文摘Sexual satisfaction following Laser or RF vaginal rejuvenation is usually assessed by straightforward self-report questionnaires that may not offer a deeper insight into female dynamics. Our randomized double-blind longitudinal clinical trial on 14 menopausal women with high FSFI satisfaction scores following laser or RF vaginal interventions, demonstrated a high positive correlation between the subjects’ FSFI scores and the Hy (hysteria), D (Depression) and L (Lie) validity scales of the MMPI-2. Such high positive correlation between the FSFI and the L-scale negates the reported increase in female sexual satisfaction following laser or RF vaginal rejuvenations. The high positive correlations of the FSFI with the Hy and D scales indicate that despite reports of increased sexual satisfaction, the vaginal procedures did not improve psychological wellbeing or quality of life. Results on the Differential Emotions Scale (DES) reveal that 98% of the subjects were organized around the emotions of shame, sadness and joy. Such results indicated a multilayered emotional organization that possibly reflects joy on the outside and shame and sadness on the inside. Results of Laser or RF vaginal rejuvenation procedures should be evaluated by a battery of tests that take into account females’ often prominent tendency to focus on satisfying their partners rather than themselves. Going down the path that starts with a dismissal of self-fulfillment to focus on their partners’ satisfaction, may bring several women to the endpoint of disingenuous interpersonal relationships tainted by repressed disillusionment.
文摘Introduction: Urinary incontinence is a common problem that can affect the quality of life of women of all ages and can negatively influence the exercise of sexuality. Aim: The aim of this study was to compare sexual function of women before and after surgical treatment for urinary incontinence. Method: The sample consisted of 38 women with urinary incontinence and surgical treatment (Burch or Sling procedure). The Female Sexual Function Index (FSFI) was used to evaluate sexual dysfunction before and after surgical treatment. Results: The mean age of the women in the study was 48 ± 8.8 years, and 58% were 50 years old or younger. By analyzing FSFI, it was observed that the majority of subjects had an overall index of sexual dysfunction (score < 26 points) before surgery. The desire and arousal domains improved significantly after surgery for all women included in the study. It was also observed that women with higher levels of education had more positive results related to desire. Conclusions: In our sample, in general, sexual function improved after surgical treatment of urinary incontinence, regardless of technique used, particularly in the discounter and pain domain. There was a substantial improvement of the sexual function among women who had presented with cystocele. Desire and arousal improved significantly after surgery, very likely due to the improvement of self-esteem after surgery.
文摘<b>Introduction:</b> Female sexual dysfunction (FSD) is a serious problem that affects negatively the quality of life, interpersonal relationships and female self- confidence and might be a direct cause of psychopathological disturbances. Female pattern hair loss (FPHL) is a common cosmetically disturbing condition affecting many women with social and psychological consequences. <b>Aim of the Work:</b> Assessment of the relationship between female sexual dysfunction and Female pattern hair loss in premenopausal females.<b> Methods:</b> A case-control study was carried on 47 female patients with FPHL and 43 age- matched control women without FPHL among premenopausal women attending dermatology and Andrology outpatient’s clinics, Suez Canal University hospital during the period from May 2018 to January 2019. History taking, clinical examination and hormonal investigation (Free Testosterone, Total Testosterone, and SHBG) were performed to all participants in the study. <b>Main Outcome Measures:</b> The Female Sexual Function Index (FSFI) was used to assess the key aspects of female sexual function in patients and controls. FPHL was diagnosed and graded by Ludwig’s classification. <b>Results:</b> Mean age of patients group was 30.12 ± 5.49 years, Regarding FPHL grading, 55.3%, 42.6% & 2.1% of patients were grades 1, 2 and 3 Ludwig’s classification respectively. FSD was found in 44.7% of patients while it was 44.2% in control group (P > 0.05). FSFI score in patients group was 26.40 ± 4.61 and in control group was 27.05 ± 3.12 (P > 0.05). Correlation between FSD prevalence and grade of FPHL by Ludwig’s classification was statistically insignificant. FSD was significantly compromised by increasing age and parity in patients and control groups (P < 0.05). <b>Conclusions:</b> The present study suggests that FSD was not significantly related to FPHL. Increased age and parity may have strong impact on sexual function in premenopausal women, while androgen hormones levels were not determinant factor.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Rheumatoid arthritis is a chronic autoimmune disease that causes socio-economic, psychological and sexual problems. It imposes limitations on sexual relationships and these issues are still taboo in African society. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> T</span></span><span style="font-family:Verdana;">he </span><span style="font-family:Verdana;">o</span><span style="font-family:Verdana;">bjective is to</span><span style="font-family:""><span style="font-family:Verdana;"> assess the impact of rheumatoid arthritis (RA) on women’s sexuality at the Ignace Deen National Hospital. </span><b><span style="font-family:Verdana;">Patients</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This was an analytic case-control study of 8 months (from April 6, 2020 to December 11, 2020). All patients followed for rheumatoid arthritis diagnosed according to 2010 ACR/EULAR criteria for RA had been included. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> One hundred and five women (52 RA patients and 53 controls) were collected. The two groups were comparable in terms of demographic characteristics. Sexual dysfunction was found in 69.2% of cases versus 35.8% of controls. Women with RA had poorer sexual functioning in the categories of desire, arousal, lubrication, orgasm, satisfaction, and pain of the FSFI score compared to healthy women (p = 0.01;p = 0.7;p = 0.3;p = 0.8;p = 0.1;and p = 0.3 respectively). Patients were 4 times more likely to have sexual dysfunction than healthy individuals and this result was statistically significant with a p-value less than 0.05. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Sexual dysfunction was noted in a large number of RA patients surveyed at the rheumatology department of the Ignace Deen national hospital. A larger study is needed to better assess this issue and seek management solutions.
文摘Background: Sexual dysfunction is sexual complaints or disorders. There are various causes, but the onset leads to deterioration of relationships and quality of life with partners. There is still a deep-rooted awareness that sexuality is a secret in Japan. Aim: This study aims to clarify the relationship between female sexual function and depression or anxiety. Method: Four hundred and fifty-eight Japanese healthy women who worked in four randomly selected medical institutions in Okinawa Prefecture in Japan from March to May 2012 were asked to agree to a consent form of their own free will and participate in self-reported questionnaires. For their evaluation, the Female Sexual Function Index (FSFI;Rosen et al. 2000, which includes the six domains of desire, arousal, lubrication, orgasm, pain, and satisfaction) and the Kessler Psychological Distress Scale (K6;Kessler, 2002, which includes the following six items: felt nervous, hopeless, restless or fidgety, worthless, depressed, and felt that everything was an effort) was used. Moreover, participants’ characteristics showed age, marriage, menopause, annual income, and drinking. In addition, JMP16.2 and R 4.2.0 was used to perform Pearson’s chi-square test, Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, Steel-Dwass test, Spearman’s Rank-Order Correlation, and Cronbach’s alpha. This study was approved by the university and the medical institutional review board (IRB). Results: 178 women were included in the final analysis, and the median (IQR, interquartile range) was 39 (32 - 48) years old, and the mean ± SD (standard deviation) was 40.2 ± 10.4 years old. The median (IQR) and mean ± SD of FSFI Total Score were 22.0 (9.3 - 26.6) and 19.2 ± 9.6. The median (IQR) and the mean ± SD of K6 Total Score were 3 (0 - 7) and 4.2 ± 4.5. 16% of all women with a K6 Total Score of 10 and more, and 5% of all women with a K6 Total Score of 13 and more considered a serious mental illness. There was no clear association between female sexual function and depression or anxiety in all health worker participants between FSFI Total Score and K6 Total Score by Spearman’s Rank-Order Correlation Coefficient (ρ). However, there was a moderate correlation between the K6 Total Score and the FSFI Total Score in health worker participants with a K6 Total Score of 11 or more (n =19, ρ = ?0.62, P = 0.005). Moreover, there was a weak correlation between them in both married and drinking women or married and non-menopausal women. In the Mann-Whitney U test where few participants had morbid depression, significant relationships were found in the association between a sexual function with high depression or anxiety, whereas the low group had a K6 cut-off value of 11. Conclusion: Female sexual morbidity for high depression or anxiety should be managed with interventions. Especially, the intervention for decreasing female sexual function in the K6 Total Score of 11 or more will be needed, and a randomized study is required for more evidence.
文摘目的研究女性性功能障碍(female sexual dysfunction,FSD)的影响因素,为围绝经期和绝经后女性生活质量的改善方法提供临床依据。方法纳入2020年4月至2021年3月在首都医科大学附属北京妇产医院及两家医联体医疗机构就诊的女性902例。收集社会人口学资料、生物学、临床特征和躯体测量指标。根据女性性功能指数(Female Sexual Function Index,FSFI)量表评估FSD将研究对象分为2组:有FSD和无FSD。根据“生殖衰老研讨会分期+10”将研究对象分期、改良Kupperman评分表(Modified Kupperman Index,KMI)评估更年期症状、心理健康问卷-9量表评价抑郁状态、国际尿失禁咨询委员会尿失禁问卷(International Consultation on Incontinent Questionnaire,ICIQ)量表评估女性压力性尿失禁、膀胱过度活动症评分(Overactive Bladder Symptom Score,OABSS)量表评估膀胱过度活动症。FSD的影响因素应用二元Logistic回归多因素分析。结果多因素分析结果显示:KMI评分(OR=1.061,95%CI:1.039~1.083)、血清卵泡刺激素(follicle stimulating hormone,FSH)(OR=1.008,95%CI:1.002~1.014)、高中以下学历(OR=1.446,95%CI:1.019~2.052)、抑郁(OR=1.814,95%CI:1.156~2.845)、绝经后早期(OR=1.717,95%CI:1.106~2.667)、绝经后晚期(OR=1.905,95%CI:1.008~3.602)、婚姻关系一般(OR=2.422,95%CI:1.711~3.429)和婚姻关系不满意(OR=1.945,95%CI:1.018~3.717)是FSD的重要危险因素(P<0.05);绝经后早期应用芬吗通治疗是FSD的重要保护因素(OR=0.229,95%CI:0.059~0.889,P<0.05)。结论FSD受心理、生理、社会等多种因素的影响,卵巢衰竭是FSD的重要危险因素,绝经后女性早期应用绝经激素治疗是FSD的保护因素。
