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。     

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。     

女性性功能障碍分类及危险因素

女性性功能障碍发病卒20％～50％，计引起个人痛苦，影响生活质量。近年来，随着对男性性生理以及性功能障碍的研究，女性性功能障碍也逐渐引起重视。女性性功能障碍的分类是建立在女性性反应周期的基础之上。其危险因素包括心理/感情因素、婚姻状态、慢性疾病、男性伙伴性功能障碍、多性伴、教育程度、女性自身解剖或炎症状态、绝经状态、药物、内分泌或手术的影响。现对其分类、定义及各种类型女性性功能障碍危险因素研究进展进行综述。     

女性性功能障碍分类及危险因素

女性性功能障碍发病率20%～50%,并引起个人痛苦,影响生活质量.近年来,随着对男性性生理以及性功能障碍的研究,女性性功能障碍也逐渐引起重视.女性性功能障碍的分类是建立在女性性反应周期的基础之上.其危险因素包括心理/感情因素、婚姻状态、慢性疾病、男性伙伴性功能障碍、多性伴、教育程度、女性自身解剖或炎症状态、绝经状态、药物、内分泌或手术的影响.现对其分类、定义及各种类型女性性功能障碍危险因素研究进展进行综述.     

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.     

产后女性性功能障碍影响因素研究进展

女性健康问题越来越受到全球重视的同时,女性性健康问题也逐渐被人们探索.国内外学者对产后女性的性功能情况进行研究,发现其影响因素多种多样,相互交叉,如:生理因素、精神心理因素、环境因素等,也带来一些具有争议的问题.本文对以上常见的影响因素进行介绍,旨在为预防和干预产后女性性健康问题提供思路,改善女性产后性健康,促进女性身...     

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。     

女性性功能障碍有遗传

英国科学家说，他们已经发现女性的性高潮和遗传因素有关。这一发现有力地驳斥了将女性性功能障碍归咎于社会和文化因素的观点。[第一段]     

女性性功能障碍的男方因素有哪些

有人说:“从来没有性冷淡的女性,有的只是蹩脚的情人。”这就是说差不多所有女性都具有能导致性高潮的性能力,不过其先决条件是要有一个博识和不可多得的伴侣。在性的环境下,爱情、亲昵和拥抱的互换是优先的,它至少可以排在与性高潮同样重要的位置。虽然一个有正常性欲的女性达到高潮主要涉及熟练的肉体刺激技术,但性欲诱导则常取决于男伴侣的心理亲近和相互影响。     

Female sexual dysfunction

This article briefly illustrates the complexities in the field of Female Sexual Dysfunction, both in terms of the circumstances in which the problems can arise, and the multiplicity of causations. It is often hard for a woman to find a language to describe the nature of her difficulty, which often means that obtaining access to appropriate professional help can be problematic. The main causes of female sexual dysfunction are outlined here, as described by the Working Group for a New View of Women’s Sexual Problems. These include social, political and economic factors, partner and relationship issues, psychological factors, and medical factors. There are difficulties with the classification of female sexual dysfunction, as current attempts neither reflect the full complexity of female sexuality, nor take account of the myriad possibilities of causation. The most commonly presenting sexual symptoms are described. These include desire and arousal problems, problems with orgasm, sexual aversion, phobia and ‘sexual anorexia’, sexual pain of non-medical origin, and vaginismus. Mention is made of life events which can trigger sexual dysfunction in women, making reference to physiological, emotional or relationship changes. The importance of careful assessment by a person skilled and trained in this field is stressed. A range of treatment options is covered, including psychological and physiological approaches, mechanical devices, and pharmacological agents. The sex therapy, programme, Sensate Focus, is included in table format. Possible referral routes are mentioned, and educational materials are listed after the references.     

Sexual desire,general arousability,and sexual dysfunction

To determine the interrelationships among neuroticism, general arousability, sexual desire, and sexual dysfunction in women, two studies were conducted. The first found a significant positive correlation between general arousability and neuroticism. The second found a curvilinear relationship between general arousability and sexual dysfunction, and a negative correlation between levels of sexual desire and sexual dysfunction. Implications for therapy with sexually dysfunctional women are discussed.     

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.     

Frequency of sexual problems and sexual dysfunction in middle-aged Danish men

The frequency of sexual dysfunction of a representative group of Danish middle-aged men was recorded, using a questionnaire and an interview that contained, respectively, 12 and 23 questions about sexual problems. The study sample consisted of 439 51-year-old men, all of whom received the questionnaire. Of these men, 100 were also interviewed. Interviewed men more frequently reported erectile dysfunction and previous contact with a therapist due to sexual problems at interview than in the questionnaire. Thus, 16 men (4% of the study population) who reported erectile dysfunction in the questionnaire constituted only a fraction of the true number. At interview nearly 40% of the men reported some kind of sexual dysfunction. There were, however, only 7% who found their problems abnormal for their age—and only 5% of the interviewed men intended to seek treatment for their problems.This project was supported by the Danish National Health Insurance Foundation (Journals H 11/118-86, H 11/80-87 and H 11/137-87) and utilized the statistical service of the Danish Medical Research Council.     

The sexual interaction of women with secondary orgasmic dysfunction and their partners

This paper reports the sexual interaction of 48 couples in which the women had secondary orgasmic dysfunction and the men reported no difficulties in sexual functioning. The results were contrasted with a sample of 63 sexually satisfied couples. On the Sexual Interaction Inventory, male and female members of the dysfunctional couples reported greater dissatisfaction with the frequency and range of specific sexual activities engaged in than their counterparts in the normative sample. Males in the dysfunctional group rated their sexual pleasure slightly higher than the norm, whereas the dysfunctional females' ratings were below average on this dimension. Within the dysfunctional group, males reported low self-acceptance and mate acceptance, while the females were less accepting of themselves but more accepting of their mates' responsivity. The female members of the dysfunctional couples had an average knowledge of their partners' sexual preferences, whereas the males were less accurate than the normative group in their perceptions of their partners' sexual preferences. As expected, the dysfunctional group reported greater overall disharmony and dissatisfaction in their sexual interaction. Implications of these findings for future research are discussed.A preliminary report of this investigation was presented at the 89th Annual Convention of the American Psychological Association, August 1981.     

女性性工作者无保护商业性行为及影响因素分析

目的 了解云南省昆明市中低收入女性性工作者(FSWs)无保护商业性行为状况及影响因素,为云南省该人群艾滋病(AIDS)综合防治提供建议。方法 利用自制问卷对昆明市4个城区561名中低收入FSWs进行调查,拟合多因素logistic回归模型探讨不安全性行为的影响因素。结果 FSWs最近3个月与嫖客发生无保护性行为的比例为58.1%(326/561);单因素分析结果表明,FSWs与嫖客发生无保护性行为有统计学意义的变量为年龄(P=0.000)、月收入(P=0.044)、从事本行业年限(P=0.001)、对健康状况关心与否(P=0.000)、最担心的疾病(P=0.000)、是否遭受过职业侵害(P=0.016)、AIDS知识得分(P=0.010)、性服务场所(P=0.000)、每月平均工作天数(P=0.000);多因素logistic回归分析结果表明,年龄(OR=0.470,95%CI=0.313~0.704)、健康状况关心与否(OR=4.249,95%CI=2.680~6.735)、最担心的疾病(OR=0.231,95%CI= 0.090~0.591)、AIDS知识得分(OR=2.371,95%CI= 1.400~4.014)、性服务场所(OR=0.852,95%CI= 0.728~0.998)、每月平均工作天数(OR=1.755,95%CI=1.099~2.801)是FSWs不安全性行为的独立影响因素。 结论 中低收入FSWs的无保护性行为更容易受到年龄、健康信念、从事本行业年限、性服务场所、每月平均工作天数以及是否受过职业侵害等因素的影响。     

Styles of sexual expression in women: Clinical implications of multivariate analyses

Two different multivariate techniques were applied to self-reported trait and behavioral data concerning sexual behavior from a sample of North American women. Canonical correlation delineated three styles in which certain demographic attributes and cognitive indices of sexual arousal were related to forms of sexual expression. The first style was characterized by respondents who experienced high rates of intercourse and orgasm in a cohabitation arrangement but who did not necessarily report satisfaction with their sexual responsivity. A second style was characterized by older women currently without partners who expressed a liking for erotic literature and media, direct genital stimulation, and frequent masturbation but who were dissatisfied with their sexual responsivity. The third style, which included respondents most satisfied with their sexual responsivity, was characterized by women who were more aware of physiological changes during sexual arousal and who enjoyed gently seductive erotic activities, breast stimulation, and genital stimulation. A discriminant analysis showed that those women who were most highly satisfied with their sexual responsivity experienced frequent intercourse and orgasm consistency, enjoyed gently seductive erotic activities and breast stimulation, but were unresponsive to erotic literature and media. A second discriminant analysis showed that women who achieved orgasm most consistently were older, were more aware of physiological changes during sexual arousal, reported higher frequencies of masturbation and intercourse, and were less likely to be aroused by erotic preliminaries. These results are discussed within the context of the literature on the treatment and prevention of sexual dysfunction.Research supported by the Dalhousie University Computer and the Psychological Services Centres.     

Sexual dysfunction in the older adult: Assessment of psychosocial factors

Until recently, the area of psychological sexual dysfunction in the older adult has been relatively ignored. A functional analysis of sexual dysfunctions among older adults continues to be lacking. Numerous general and age-specific psychosocial factors are implicated in development and maintenance of sexual dysfunction among older adults. These factors are discussed in the context of our model of sexual dysfunction. Assessment strategies and questions are provided following from the Sexual Dysfunction Interview, a semi-structured interview. The opinions or assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the Department of Defense or the Uniformed Services University of the Health Sciences.     

Assessment of sexual beliefs and information in aging couples with sexual dysfunction

The incidence and prevalence of sexual dysfunction indicate that a large portion of the U.S. population will experience a sexual dysfunction, with older individuals being particularly at risk. Cognitive factors (e.g., attitudes, misinformation, beliefs) may contribute to the development of sexual dysfunction or influence response to treatments. The purpose of the current study was to evaluate the psychometric properties of a brief instrument designed to assess information and beliefs regarding sexual functioning in an aging population. Results indicate that the Sexual Beliefs and Information Questionnaire (SBIQ) had adequate test-retest reliability and is an internally consistent measure of sexual knowledge and beliefs. Most individuals had adequate knowledge regarding sexual functioning as indicated by correct responses to most items; however, there were several items missed more often than expected. Exploratory factor analysis suggests an underlying five-factor structure of the SBIQ. Scores were not correlated with years of education, mood, or marital satisfaction. Scores on the SBIQ improved after a brief standardized educational intervention. The SBIQ is a simple and psychometrically sound measure of sexual knowledge and myths that can assist clinicians to identify and possibly rectify knowledge deficits.