Sarrel P M
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
J Womens Health Gend Based Med. 2000;9 Suppl 1:S25-32. doi: 10.1089/152460900318830.
Investigators continue to define the exact relationship between sexual function and changes in hormonal status during menopause. The availability of different preparations that could replace estrogens and androgens has led to many studies of the use of hormone replacement therapy (HRT) for sexual dysfunction. Dyspareunia due to vaginal dryness appears to be most responsive to estrogen replacement therapy (ERT) via restoration of vaginal cells, pH, and blood flow. Progestins, to a certain extent, can oppose these changes and lead to a recurrence of dryness and dyspareunia. ERT has also been reported to enhance sexual desire in a significant percent of women. Although treatment with ERT has been shown to be efficacious for many women, there are others whose sexual difficulties remain unresponsive. There also appears to be a significant subgroup of women whose sexual difficulties respond initially to ERT but who subsequently revert to their initial problems, especially when the problem has been loss of libido. For these women, the addition of androgen has proved helpful.
研究人员仍在继续明确性功能与绝经期间激素状态变化之间的确切关系。多种可替代雌激素和雄激素的制剂的出现，引发了许多关于使用激素替代疗法（HRT）治疗性功能障碍的研究。因阴道干燥引起的性交困难似乎对雌激素替代疗法（ERT）反应最为明显，这是通过恢复阴道细胞、pH值和血流来实现的。在一定程度上，孕激素会抵消这些变化，导致干燥和性交困难复发。据报道，ERT也能在相当比例的女性中增强性欲。虽然ERT治疗已被证明对许多女性有效，但仍有其他女性的性问题未得到改善。似乎还有相当一部分女性，她们的性问题最初对ERT有反应，但随后又恢复到最初的问题，尤其是当问题是性欲减退时。对于这些女性，添加雄激素已被证明是有帮助的。
