da Silva Lara Lucia Alves, Useche Bernardo, Rosa E Silva Julio Cesar, Ferriani Rui Alberto, Reis Rosana Maria, de Sá Marcos Felipe Silva, de Carvalho Bruno Ramalho, Carvalho Maria Angela Cury Ramos, de Sá Rosa E Silva Ana Carolina Japur
Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, São Paulo University, Brazil-University Hospital, 14049-900 Ribeirão Preto, SP, Brazil.
Maturitas. 2009 Feb 20;62(2):127-33. doi: 10.1016/j.maturitas.2008.12.014. Epub 2009 Jan 30.
Cultural, social, physiological and psychological factors may alter the course of sexual function in climacteric women.
The objective of the present literature review is to survey the prevalence of sexual dysfunctions in the climacteric and to establish the association between the organic and psychic changes that occur during this phase and sexual dysfunction. We also discuss potential treatments.
We evaluated the data available in PubMed (1982-2008). For each original article, two reviewers analyzed the data independently and considered a study to be of high quality if it had all three of the following characteristics: prospective design, valid data and adequate sample size. Both reviewers extracted data from each of the 99 studies selected: 34 cross-sectional studies, 25 cohort studies, 9 trials, 31 reviews related to sexuality in pre- and post-menopausal women.
Sexual dysfunction among climacteric women is widespread and is associated with bio-psychosocial factors. However, there is not enough evidence to correlate sexual dysfunction with a decrease in estrogen levels and biological aging. A strong association exists between climacteric genital symptoms and coital pain. There is, however, sufficient evidence demonstrating the benefits of local estrogen therapy for patients with genital symptoms.
A significant decline in sexual function occurs in climacteric women, although it is still unclear whether this is associated with the known decrease in estrogen levels or with aging, or both. Relational factors may interfere with sexual function during this phase. The climacteric genital symptoms improve with estrogen replacement therapy, and positively influence sexual function. Further studies are needed to establish the actual impact of the decrease in estrogen levels and of aging on the sex life of climacteric women.
文化、社会、生理和心理因素可能会改变更年期女性的性功能进程。
本综述的目的是调查更年期性功能障碍的患病率，并确定该阶段发生的器质性和心理变化与性功能障碍之间的关联。我们还将讨论潜在的治疗方法。
我们评估了PubMed（1982 - 2008年）中可用的数据。对于每篇原始文章，两名评审员独立分析数据，若一项研究具备以下所有三个特征，则认为其质量较高：前瞻性设计、有效数据和足够的样本量。两名评审员从选定的99项研究中提取数据：34项横断面研究、25项队列研究、9项试验、31篇与绝经前后女性性行为相关的综述。
更年期女性性功能障碍普遍存在，且与生物心理社会因素相关。然而，没有足够的证据将性功能障碍与雌激素水平降低和生物衰老联系起来。更年期生殖器症状与性交疼痛之间存在密切关联。然而，有充分的证据表明局部雌激素治疗对有生殖器症状的患者有益。
更年期女性性功能显著下降，尽管目前尚不清楚这是否与已知的雌激素水平下降或衰老或两者都有关。人际关系因素可能会在这个阶段干扰性功能。更年期生殖器症状通过雌激素替代疗法得到改善，并对性功能产生积极影响。需要进一步研究以确定雌激素水平下降和衰老对更年期女性性生活的实际影响。
