人乳头瘤病毒感染患者性功能障碍发生状况及影响因素分析

目的:研究人乳头瘤病毒(human papilloma virus,HPV)感染女性性功能障碍(female sexual dysfunction,FSD)发生状况及相关影响因素。方法:选取2019年5-7月在首都医科大学附属北京妇产医院妇瘤科门诊就诊的HPV阳性患者300例作为研究对象,通过填写一般问卷及女性性功能指数量表(FSFI)收集资料,分析HPV感染患者FSD发生现状及相关影响因素。结果:300例患者中,FSD发生率为81.00%(243/300),平均FSFI评分为(17.34±9.73)分。在性功能的6个维度中,出现障碍的比例由高到低依次是性欲低下(82.00%)、性满意度下降(69.00%)、性唤起困难(66.67%)、性高潮障碍(62.33%)、性交疼痛(52.00%)、阴道润滑困难(49.33%)。不同年龄、文化程度、职业、收入、焦虑与否的HPV感染患者FSD发生率差异有统计学意义(均P<0.05)。Logistic回归分析显示,年龄>40岁(OR=7.747,95%CI:3.329~18.030,P<0.001)、高中/大专及以下学历(OR=4.029,95%CI:1.540~10.542,P=0.005)、焦虑(OR=4.028,95%CI:1.713~9.472,P=0.001)是HPV感染患者发生FSD的独立影响因素。结论:HPV感染患者的FSD发生率较高,其FSFI评分明显降低,性功能的6个维度中,性欲低下的发生率最高。对于年龄>40岁、高中/大专及以下学历以及合并焦虑的HPV感染患者应尤其重视,早期识别并给予干预,改善其生活质量。     

人乳头瘤病毒感染患者性功能障碍发生状况及影响因素分析

目的:研究人乳头瘤病毒(human papilloma virus,HPV)感染女性性功能障碍(female sexual dysfunction,FSD)发生状况及相关影响因素。方法:选取2019年5—7月在首都医科大学附属北京妇产医院妇瘤科门诊就诊的HPV阳性患者300例作为研究对象,通过填写一般问卷及女性性功能指数量表(FSFI)收集资料,分析HPV感染患者FSD发生现状及相关影响因素。结果:300例患者中,FSD发生率为81.00%(243/300),平均FSFI评分为(17.34±9.73)分。在性功能的6个维度中,出现障碍的比例由高到低依次是性欲低下(82.00%)、性满意度下降(69.00%)、性唤起困难(66.67%)、性高潮障碍(62.33%)、性交疼痛(52.00%)、阴道润滑困难(49.33%)。不同年龄、文化程度、职业、收入、焦虑与否的HPV感染患者FSD发生率差异有统计学意义(均P0.05)。Logistic回归分析显示,年龄40岁(OR=7.747,95%CI:3.329～18.030,P0.001)、高中/大专及以下学历(OR=4.029,95%CI:1.540～10.542,P=0.005)、焦虑(OR=4.028,95%CI:1.713～9.472,P=0.001)是HPV感染患者发生FSD的独立影响因素。结论:HPV感染患者的FSD发生率较高,其FSFI评分明显降低,性功能的6个维度中,性欲低下的发生率最高。对于年龄40岁、高中/大专及以下学历以及合并焦虑的HPV感染患者应尤其重视,早期识别并给予干预,改善其生活质量。     

女性性功能障碍的流行病学研究

女性性功能障碍 ( Female sex dysfunction,FSD)是指个体不能参与她所期望的性行为〔1〕。它常常与社会心理因素密切相关 ,但不是其他精神障碍的—部分 〔2〕。性功能障碍可表现为性欲减退或缺失、性厌恶及性乐缺乏、生殖器反应丧失、性高潮功能障碍、非器质性阴道痉挛、非器质性性交疼痛和性欲亢进等〔3〕。综合国内外的文献 ,对女性性功能障碍的研究较少 ,但同时女性的性功能障碍又严重影响着女性的个人生活和生殖健康。故本文将从 FSD的发生率、分类及定义、影响因素及结果 4个方面进行论述。1　 FSD的发生率女性性功能障碍与年龄有…     

女性性功能障碍的诊断

由于女性性反应的复杂性以及女性性功能障碍(female sexual dysfunction,FSD)基础研究的匮乏,导致FSD的诊断标准和命名系统非常复杂。目前常用的FSD分类标准有世界卫生组织(WHO)制定的国际疾病和相关健康问题统计学分类-10(International Classifications of Diseases-10,ICD-10)、美国精神病学会(American Psychiatric Association,APA)制定的精神疾病诊断与统计学手册第4版、第5版(The Diagnostic and Statistical Manual of Mental Disorders-IV/V,DSM-IV、DSM-V)、美国泌尿系统疾病基金会性健康委员会(The Sexual Function Health Council of the American Foundation for Urologic Disease,AFUD)制定的国际专家认可的FSD分类(The Consensus-based Classification of Female Sexual Dysfunction,CCFSD)。这些命名系统基于性反应周期的线性模型将FSD分为4大类:性欲障碍、性唤起障碍、性高潮障碍和性交疼痛障碍。     

生物反馈电刺激治疗围绝经期女性性功能障碍及对盆底肌力影响

目的：分析生物反馈电刺激联合雌激素和Kegel训练法盆底肌肉康复训练治疗围绝经期女性性功能障碍(FSD)疗效及对盆底肌力的影响。方法：选择2020年5月-2022年5月本院妇产科就诊的围绝经期FSD患者80例，随机数据表法为两组各40例，对照组给予阴道内局部应用雌激素联合Kegel训练法盆底肌肉康复训练，观察组在对照组基础上联合应用生物反馈电刺激治疗，均连续治疗8周。对两组治疗前后女性性功能指数量表(FSFI)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分及盆底肌力分级进行评价和对比。结果：治疗后两组FSFI评分较治疗前升高，SAS评分和SDS评分均较治疗前下降(P<0.05),观察组治疗后FSFI评分(31.18±2.31分)及盆底肌力分级均高于对照组(23.34±5.08分),SAS评分(44.06±3.35分)和SDS评分(45.81±5.22分)均低于对照组(53.54±2.39分、57.10±3.61分)(均P<0.05)。结论：围绝经期FSD患者局部应用雌激素基础上联合应用生物反馈电刺激和Kegel训练法进行盆底肌肉康复，能够显著改善患者性功能和心...     

上海闸北区围绝经期妇女性功能障碍调查分析

目的调查分析上海闸北社区围绝经期妇女性功能障碍（FDS）发生情况,为延缓围绝经期妇女性功能障碍提供性知识的健康教育。方法选择2011年5月至9月上海闸北区北面区域社区居民中在本院进行健康体检的40～65岁围绝经期妇女825例为调查对象,并采用女性性功能指数（FSFI）问卷评估性功能调查,分析围绝经期妇女性功能障碍的发生率及相关影响因素。结果发放调查表825份,收回有效调查表746份,有效问卷回收率90．42％。本组40～65岁女性FSFI得分（16．45±4．33）分,FSD总的发生率为86．7％,围绝经期妇女随年龄的增长,FSn评分及单项评分逐渐下降（P〈0．05）,FSD发生率升高（P〈0．05）,以性满意度下降（72．9％）、性交疼痛（70．5％）和性高潮障碍（70．2％）为主。结论围绝经期妇女性功能障碍发生率高,伴有不同程度性功能障碍,以性满意度下降、性交疼痛和性高潮障碍为主。对围绝经期妇女进行性知识的健康教育,可改善其性生活质量,有利于延缓衰老。     

女性性功能障碍与不孕

女性性功能障碍(female sexual dysfunction,FSD)发病率较高,国内妇女达70%左右,国外妇女为20%～50%.90%FSD为心理因素引起[1].不孕症(infertility)近年来发病率也呈上升趋势,有10%～20%为不明原因的不孕症[2].在临床工作中,女性不孕因素以排卵障碍及输卵管因素为主,对女性性功能障碍很少提及.为揭示不明原因的不孕症是否与FSD有关,现就女性性功能障碍及其与不孕之间的相互关系综述、分析如下.     

女性性高潮障碍相关因素分析

目的:探讨女性性高潮障碍的相关危险因素,为女性性高潮障碍的防治提供依据。方法:采用回顾性调查方法,对2009年3月～12月在南京医科大学附属南京市妇幼保健院进行健康体检的20岁以上女性及其女性陪护人进行问卷调查,应用女性性功能指数(FSFI)问卷评估性功能,性高潮评分<4.0分为性高潮障碍的诊断标准,采用多因素Logistic回归进行多因素分析。结果:共发放问卷2 658份,有1 856例女性完成问卷,问卷回收率69.8%。剔除性唤起障碍者602例,其余性唤起正常的855例中性高潮障碍者298例,占34.9%(298/855)。Logistic多因素分析表明,年龄(≥40岁)、难产、对居所不满意、绝经、性交疼痛、配偶性功能障碍等是女性性高潮障碍的独立危险因素(P<0.05)。结论:女性性高潮障碍的发生与年龄(≥40岁)、难产、对居所满意度、绝经、性交疼痛、配偶性功能障碍多种因素相关。     

上海某区中老年女性性功能的影响因素分析*

目的 探讨上海某区中老年女性性功能的影响因素。方法 选取2018年10月—2019年3月上海市某区中老年妇女1743名,采用德国版的女性性功能指数（FSFI）评估性功能,分析中老年女性性功能影响因素。结果 1743名中老年妇女中,FSFI得分8~36分、平均（28.13±4.23）分,性功能良好者1 316名（75.50%）、性功能不良者427名（24.50%）;单因素分析结果显示,中老年女性性功能与年龄、认知、更年期症状有关（P<0.05）,但与文化程度、婚姻状态、内科慢性病无关（P>0.05）;logistic回归分析显示,年龄、认知以及更年期症状是中老年女性性功能的独立影响因素。结论 上海某区中老年女性性功能较良好,但其受年龄、认知、更年期症状等因素影响。     

女性性功能障碍的诊治进展

<正>女性性功能障碍(FSD)是一种与年龄相关且渐进发展的疾病,主要包括性欲障碍、性唤起障碍、性高潮障碍、性疼痛障碍等类型。FSD与年龄、抑郁、受教育水平低下、饮酒、绝经期/绝经后期、慢性疾病、配偶健康状况不良、难产、离异等多种因素密切相关〔1〕。张爱霞等〔2〕发现南京市城区FSD发病率达     

Vitamin E and ginseng supplementation to enhance female sexual function: a randomized,double-blind,placebo-controlled,clinical trial

ABSTRACT

Female sexual disorders (FSD) are a spectrum of disorders common among women, especially in their middle age, which can reduce the female quality of life substantially. We aimed to evaluate the effects of a combined vitamin E and ginseng supplement on amelioration of female sexual dysfunction. In a 6-week, double-blind, randomized, placebo-controlled clinical trial, participants, suffering from sexual dysfunction based on the female sexual function index (FSFI) questionnaire, were randomly allocated to receive the supplement (100 IU vitamin E, 67 mg Korean ginseng, and 40 mg Siberian ginseng) or placebo daily. The primary outcome in our trial was the change in the FSFI total score. Sixty-nine participants were enrolled, but only 31 in each group completed the trial. Changes in the FSFI total score and its domain scores were significant during the trial course within each group. However, the supplement only ameliorated desire and satisfaction domains superior to the placebo. In case of the total score and other domains, the changes were insignificantly different between the treatment groups. Although our study could not find additional benefits for the vitamin E and ginseng supplement over placebo in enhancing sexual function overall, the supplement worked better in enhancing sexual desire and satisfaction.     

女性性功能障碍及其研究进展

女性性功能障碍是影响女性生活质量的一个重要因素,随着社会的进步,性功能障碍问题日益受到人们的重视。近年的研究表明,女性性功能障碍的发生与女性社会心理因素、生理及病理改变有密切关系;同时,对女性性生理、女性性功能障碍发病机制的深入认识和理解,也为女性性功能障碍的诊断和治疗提供了理论依据。     

The relationship between menopausal symptoms and sexual function

Sexual function could be affected by several factors in postmenopausal women. This cross-sectional study aimed to investigate the relationship between the severity of menopausal symptoms and sexual function. The study was conducted among 405 postmenopausal women aged 40–65 years, in Chalous and Noshahr, Iran, from October 2013 to May 2014. The participants were selected using a multistage sampling method. The instruments used for data collection were the Female Sexual Function Index (FSFI), the Menopause Rating Scale (MRS), and a demographics questionnaire. The relationship between the severity of menopausal symptoms and sexual function was examined using Pearson’s correlation coefficient and multiple linear and logistic regressions. The mean unadjusted FSFI and MRS scores were 24.11 and 12.45, respectively; and 61.0 percent of the participants had female sexual dysfunction (FSD) (FSFI ≤26.55). A significant negative correlation was observed between the MRS scores (total and all subscales) and the total scores for FSFI (p < 0.001). The results of the logistic regression analysis showed that with every unit increase in the total score of MRS, the likelihood of sexual dysfunction was 9.6 percent greater. We conclude that menopausal symptoms need to be considered in the design of health initiatives aimed at postmenopausal women’s sexual function.     

A Discordant Monozygotic Twin Approach to Testing Environmental Influences on Sexual Dysfunction in Women

The present study explored the causal role played by putative environmental factors on variation in female sexual dysfunction (FSD) by investigating FSD discordant monozygotic (MZ) twins, which permits a control over genetic confounders. In a population-based sample of female twins aged 25–69 years (M = 55 years), MZ twins discordant for recent and lifelong FSD were selected. Sample sizes varied depending on the specific sexual problem (N = 33–90 pairs). The Female Sexual Function Index (FSFI) score was used to discriminate cases from controls. Once genetic factors were controlled for, relationship satisfaction emerged as the strongest independent predictor for recent and lifelong FSD, being associated with FSFI dimensions measuring desire, arousal, and lubrication problems. The association with orgasm problems was especially strong (OR 7.1, 95 % CI: 1.9–25.3) as was the association with sexual dissatisfaction (OR 5.1, 95 % CI: 2.1–12.1). Furthermore, obsessive–compulsive symptomatology was weakly associated with desire problems (OR 1.5, 95 % CI: 1.4–1.8) and anxiety-sensitivity with orgasm problems (OR 1.1, 95 % CI: 0.9–1.3). Negligible effects were found for personality factors and small effects for self-reported abusive experiences. These data indicate, for the first time, that in women at identical genetic risk, relationship factors play a key role in the development of sexual problems. These findings require replication in prospective designs which can provide additional powerful tests of the direction of causality between interpersonal factors and later sexual dysfunction.     

The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores

The Female Sexual Function Index (FSFI) is a brief multidimensional scale for assessing sexual function in women. The scale has received initial psychometric evaluation, including studies of reliability, convergent validity, and discriminant validity (Meston, 2003; Rosen et al., 2000). The present study was designed to crossvalidate the FSFI in several samples of women with mixed sexual dysfunctions (N = 568) and to develop diagnostic cut-off scores for potential classification of women's sexual dysfunction. Some of these samples were drawn from our previous validation studies (N = 414), and some were added for purposes of the present study (N = 154). The combined data set consisted of multiple samples of women with sexual dysfunction diagnoses (N = 307), including female sexual arousal disorder (FSAD), hypoactive sexual desire disorder (HSDD), female sexual orgasm disorder (FSOD), dyspareunia/vaginismus (pain), and multiple sexual dysfunctions, in addition to a large sample of nondysfunctional controls (n = 261). We conducted analyses on the individual and combined samples, including replicating the original factor structure using principal components analysis with varimax rotation. We assessed Cronbach's alpha (internal reliability) and interdomain correlations and tested discriminant validity by means of a MANOVA (multivariate analysis of variance; dysfunction diagnosis x FSFI domain), with Bonferroni-corrected post hoc comparisons. We developed diagnostic cut off scores by means of standard receiver operating characteristics-curves and the CART (Classification and Regression Trees) procedure. Principal components analysis replicated the original five-factor structure, including desire/arousal, lubrication, orgasm, pain, and satisfaction. We found the internal reliability for the total FSFI and six domain scores to be good to excellent, with Cronbach alpha's >0.9 for the combined sample and above 0.8 for the sexually dysfunctional and nondysfunctional samples, independently. Discriminant validity testing confirmed the ability of both total and domain scores to differentiate between functional and nondysfunctional women. On the basis of sensitivity and specificity analyses and the CART procedure, we found an FSFI total score of 26.55 to be the optimal cut score for differentiating women with and without sexual dysfunction. On the basis of this cut-off we found 70.7% of women with sexual dysfunction and 88.1% of the sexually functional women in the cross-validation sample to be correctly classified. Addition of the lubrication score in the model resulted in slightly improved specificity (from .707 to .772) at a slight cost of sensitivity (from .881 to .854) for identifying women without sexual dysfunction. We discuss the results in terms of potential strengths and weaknesses of the FSFI, as well in terms of further clinical and research implications.     

Do Iranian Women with Endometriosis Suffer from Sexual Dysfunction?

Endometriosis is a gynecological disorder. One of the most disabling clinical problems of affected women is pain syndrome which presenting with dysmenorrhea and dyspareunia. Sexual dysfunction is one of the health problems is these women which is not regarded as it should be. The goal of this study was to evaluate sexual function in Iranian women with endometriosis in comparison with healthy controls. Forty-six married women with confirmed endometriosis and 80 healthy subjects enrolled. Participants were asked to answer the valid and reliable Persian version of Female Sexual Function Index (FSFI) questionnaire. The most common clinical symptom were dysmenorrheal and dyspareunia. The mean Visual Analogue Scale for pain during sex was 37.4 ± 35.7 and mean sexual activity satisfaction was 64.4 ± 33.6 %. Total FSFI score and scores of three out of six subscales (arousal, orgasm and pain) were significantly different between patients and controls. By considering 26.55 as cut off point, we found that education level and body mass index (BMI) were significantly different in patients with and without sexual dysfunction. BMI was the independent predictor for total FSFI score in both case and control groups. Iranian women with endometriosis exhibited significant dysfunction in most domains of FSFI questionnaire. So, sexual dysfunction should be considered in Iranian women with endometriosis.     

High Prevalence of Sexual Dysfunction in Women with Rheumatic Diseases: A not Recognized Health Domain

Objective

To measure the sexual satisfaction and the prevalence of dysfunction in women with rheumatic diseases.

Methods

A cross-sectional study was conducted, in which the patients were enrolled in two clinical settings; Public Health Insurance and Social Security Service. The presence of sexual dysfunction was assessed with the questionnaire ‘Female Sexual Function Index (FSFI)’. The FSFI was self-administered and consisted of 19 questions covering six domains; desire, subjective arousal, lubrication, orgasm and pain. The patients’ answers were based on the 4 weeks prior to completing the questionnaire. A total score of ≤?26 indicated sexual dysfunction.

Results

451 women participated, mean age of 49.27 years (SD 13.58). The most frequent diagnoses were: Rheumatoid Arthritis (234, 51.9%), Systemic Lupus Erythematous (58, 12.9%), Osteoarthritis (35, 7.8%) and Fibromyalgia (25, 5.5%). The median FSFI score was 12.3 (IQR 12.8) and sexual dysfunction was found in 94.9% of patients. Median and IQR scores for each domain were as follows: desire 5.4 (2.4), subjective arousal 1.2 (3.3), lubrication 2.1 (3.9), orgasm 0 (3.6), satisfaction 2.4 (1.2) and pain 0 (4.8). There was no difference found between the rheumatic diseases studied and the FSFI score or the percentage of patients with sexual dysfunction. There is a negative correlation (Spearman rho ??0.328, p?=?0.01) between age and the final score, a positive correlation between age and (0.449, p?=?0.01) desire, and a negative correlation with the remaining categories: subjective arousal (rho?=? ??0.351, p?=?0.01), lubrication (rho?=? ??0.387, p?=?0.01), orgasm (rho?=? ??0.346, p?=?0.01), and pain (rho?=? ??0.411, p?=?0.01).

Conclusion

The sexual dysfunction frequency in rheumatic patients is high. It is necessary to investigate and act on this problem to increase the quality of life of our patients.