Gelfand M M
Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
J Womens Health Gend Based Med. 2000;9 Suppl 1:S15-20. doi: 10.1089/152460900318812.
The population of the world is living longer. Currently, the average life expectancy is 78.9 and 72 years of age for women and men, respectively. By the year 2030, it is estimated that elderly people will make up approximately 17% of the total United States population. Our responsibility as physicians is, therefore, very clear. The care of this population must provide an acceptable quality of life and allow elderly people to enjoy living. This is where the question of sexuality plays an important part. Hormonal transition encompasses decreased levels of estrogen and testosterone, the latter being associated with decreased sexual libido, sensitivity, and response. Additional genitourinary effects associated with menopause include atrophic changes in the vagina, vulva, urethra, and neck of the bladder. Vaginal atrophy and diminished vaginal lubrication interfere mechanically with sexual comfort and pleasure. In addition to hormonal changes with aging, disease and associated medications may also negatively affect sexuality. Determining the impact of medications, both alone and in combination with others, on quality of life must be considered when providing comprehensive care for elderly patients.
世界人口的寿命在延长。目前，女性和男性的平均预期寿命分别为78.9岁和72岁。据估计，到2030年，老年人将占美国总人口的近17%。因此，我们作为医生的责任非常明确。对这一人群的护理必须提供可接受的生活质量，让老年人享受生活。这就是性问题发挥重要作用的地方。激素转变包括雌激素和睾酮水平下降，后者与性欲、敏感度和反应能力降低有关。与更年期相关的其他泌尿生殖系统影响包括阴道、外阴、尿道和膀胱颈的萎缩性变化。阴道萎缩和阴道润滑减少会在机械上干扰性舒适度和愉悦感。除了衰老带来的激素变化外，疾病和相关药物也可能对性功能产生负面影响。在为老年患者提供全面护理时，必须考虑药物单独或与其他药物联合使用对生活质量的影响。
