Stuckey Bronwyn G A
Department of Endocrinology and Diabetes, Keogh Institute for Medical Research, Sir Charles Gairdner Hospital, School of Medicine and Pharmacology, University of Western Australia, Nedlands, WA, Australia.
J Sex Med. 2008 Oct;5(10):2282-90. doi: 10.1111/j.1743-6109.2008.00992.x.
Sexual function in women in the reproductive age years is under psychological, sociocultural, and relationship influences, as well as the influence of sex hormones.
To examine the data relating to sexual function in women in the reproductive age group, particularly the influence of sex hormones. To examine, in particular, the influence of the menstrual cycle, pregnancy, the oral contraceptive pill and endogenous and exogenous testosterone.
Review of the literature on female sexual function, confining the search to the reproductive age range.
Population studies of sexual function identify sexual disinterest as being the most common sexual complaint in premenopausal women. Most studies of menstrual cyclicity identify a periovulatory increase in sexual desire or activity. All prospective studies of sexuality in pregnancy document a decline in sexual function with progression of pregnancy. Studies of the influence of the oral contraceptive pill on sexual function are contradictory with most prospective controlled studies showing no deleterious effect. Studies of the influence of endogenous androgens on sexuality are also contradictory with one large cross-sectional study showing no correlation, but some case-controlled studies show low androgens in women with sexual dysfunction. Studies of testosterone therapy in premenopausal women are ambiguous, with no clear dose-response effect.
Sexual disinterest is prevalent in premenopausal woman despite being hormone replete. The assessment of androgen contribution is hampered by the unreliability of the testosterone assay in the female range. Large cross-sectional and longitudinal studies have not identified a correlation between testosterone and sexual function in women. Sexual dysfunction in the premenopausal age range is common. Sex hormones have a modifying effect on sexual function but social influences and learned responses are as important. The role of testosterone requires further study.
育龄期女性的性功能受到心理、社会文化及人际关系的影响，同时也受性激素的影响。
研究育龄期女性性功能相关数据，尤其是性激素的影响。特别研究月经周期、妊娠、口服避孕药以及内源性和外源性睾酮的影响。
回顾关于女性性功能的文献，检索范围限定在育龄期。
性功能的人群研究表明，性兴趣缺乏是绝经前女性最常见的性问题。大多数关于月经周期的研究发现，排卵期前后性欲或性活动会增加。所有关于孕期性活动的前瞻性研究都表明，随着孕期进展性功能会下降。关于口服避孕药对性功能影响的研究结果相互矛盾，大多数前瞻性对照研究表明没有有害影响。关于内源性雄激素对性活动影响的研究也相互矛盾，一项大型横断面研究表明两者没有相关性，但一些病例对照研究显示性功能障碍女性的雄激素水平较低。绝经前女性睾酮治疗的研究结果不明确，没有明确的剂量反应效应。
尽管激素水平充足，但性兴趣缺乏在绝经前女性中很普遍。女性睾酮检测结果的不可靠性妨碍了对雄激素作用的评估。大型横断面和纵向研究尚未发现女性睾酮与性功能之间存在相关性。绝经前年龄段的性功能障碍很常见。性激素对性功能有调节作用，但社会影响和习得反应同样重要。睾酮的作用需要进一步研究。
