Bachmann Gloria A, Leiblum Sandra R
Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ 08901, USA.
Menopause. 2004 Jan-Feb;11(1):120-30. doi: 10.1097/01.GME.0000075502.60230.28.
Menopause is associated with physiological and psychological changes that influence sexuality. During menopause, the primary biological change is a decrease in circulating estrogen levels. Estrogen deficiency initially accounts for altered bleeding and diminished vaginal lubrication. Continual estrogen loss often leads to numerous signs and symptoms, including changes in the vascular and urogenital systems. Alterations in mood, sleep, and cognitive functioning are common as well. These changes may contribute to lower self-esteem, poorer self-image, and diminished sexual responsiveness and sexual desire. Other important nonhormonal factors that affect sexuality are health status and current medications, changes in or dissatisfaction with the partner relationship, social status, and cultural attitudes toward older women. The problems in sexual functioning related to estrogen deficiency can be treated with hormone therapy that includes estrogens alone and estrogens combined with androgens. Vaginal lubricants and moisturizers also may be useful in ameliorating postmenopausal sexual complaints. This article reviews the literature on the impact of menopausal estrogen loss on sexuality and on the effect of hormone therapy on sexual function during menopause.
更年期与影响性功能的生理和心理变化相关。在更年期期间，主要的生物学变化是循环雌激素水平下降。雌激素缺乏最初表现为出血改变和阴道润滑减少。持续的雌激素流失通常会导致许多体征和症状，包括血管和泌尿生殖系统的变化。情绪、睡眠和认知功能的改变也很常见。这些变化可能导致自尊降低、自我形象变差以及性反应和性欲减弱。其他影响性功能的重要非激素因素包括健康状况和当前用药、伴侣关系的变化或不满、社会地位以及文化对老年女性的态度。与雌激素缺乏相关的性功能问题可以通过激素疗法治疗，包括单独使用雌激素以及雌激素与雄激素联合使用。阴道润滑剂和保湿剂也可能有助于改善绝经后的性问题。本文综述了关于绝经后雌激素流失对性功能的影响以及激素疗法对更年期性功能影响的文献。
