围绝经期及绝经后女性性功能障碍状况及与更年期症状的关系分析

目的 调查围绝经期及绝经后女性性功能障碍状况，分析更年期症状对女性性功能障碍（female sexual dysfunction，FSD）的影响。方法 选取2019年6月至2019年10月在首都医科大学附属北京妇产医院内分泌科就诊的40岁以上女性180例进行问卷调查，根据生殖衰老分期研讨会（Stages of Reproductive Aging Workshop，STRAW+10）标准将研究对象分为4组：绝经过渡早期（A组）、绝经过渡晚期（B组）、绝经后期早期（C组）、绝经后期晚期（D组）。应用改良Kupperman评分表（Modified Kupperman Index，KMI）评价女性更年期症状；女性性功能指数（Female Sexual Function Index，FSFI）量表评价女性性功能障碍。结果 随着生殖衰老分期的提高，4组患者的年龄中位数逐渐增大，从45.5岁提高到57.0岁；与伴侣共同生活时间的年限中位数从20年增加到23.5年，性生活的间隔时间中位数从7 d增加到15 d；KMI中位数从9.5分提高到15分（P<0.05）。随着生殖衰老分期的升高，FSD和性欲障碍、性唤起障碍、阴道湿润障碍、性高潮障碍、性满意度障碍和性交痛的患病率均明显升高（P<0.05）。FSD和性欲障碍、性唤起障碍、阴道湿润障碍、性高潮障碍、性满意度障碍和性交痛的患病率随更年期症状的严重程度提高而升高（P<0.05）。结论 随着女性生殖衰老分期的提高，FSD的患病率明显升高。出现更年期症状以及其严重程度是40岁以上女性发生FSD的重要影响因素，应积极治疗更年期症状以提高女性的生活质量。

Prevalence of female sexual dysfunction and the relationship between climacteric symptoms and female sexual dysfunction in Chinese women with menopause transition stage and postmenopausal stage

Objective To investigate the effects of climacteric symptoms on female sexual dysfunction(FSD) at different reproductive aging stages. Methods A cross-sectional study including 180 cases was conducted among women over 40 years old in the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China, from Jun. 2019 to Oct. 2019. According to the 2011 stages of the Reproductive Ageing Workshop (STRAW+10), the subjects were divided into four groups:early menopausal transition stage (group A), late menopausal transition stage (group B), early postmenopausal stage (group C), and late postmenopausal stage (group D). Female climacteric symptoms were evaluated by Modified Kupperman Index (KMI), and FSD was evaluated by Female Sexual Function Index (FSFI). Results With the increase of stages of the reproductive aging, the median age of the subjects increased from 45.5 years to 57.0 years, the median years of cohabitation with their partners increased from 20 years to 23.5 years, the median time of sexual frequency increased from 7 days to 15 days, and the median KMI increased from 9.5 to 15 days (P<0.05). With the increase of stages of the reproductive aging, the prevalence of FSD and sexual desire disorder, sexual arousal disorder, vaginal lubrication disorder, orgasm disorder, sexual satisfaction disorder, and vaginal pain were significantly increased (P<0.05). The prevalence of FSD and sexual desire disorder, sexual arousal disorder, vaginal lubrication disorder, orgasm disorder, sexual satisfaction disorder, and vaginal pain increased with the severity of menopausal symptoms (P<0.05). Conclusion With advanced stage of reproductive aging, FSD was prevalent significantly. The prevalence of FSD was higher in women with menopausal symptoms. The more severe the menopausal symptoms were, the higher the prevalence of FSD was. Climacteric symptoms and their severity are important factors affecting the occurrence of FSD in women over 40 years old. Climacteric symptoms should be actively treated to improve the quality of life of women.