Department of Surgical Sciences, University of L'Aquila, L'Aquila, Italy.
Menopause. 2009 Nov-Dec;16(6):1188-92. doi: 10.1097/gme.0b013e3181a6b491.
The aim of this study was to evaluate the relationship between body mass index (BMI) and female sexual dysfunction (FSD) among perimenopausal and postmenopausal women with urinary incontinence (UI).
From 2005 to 2008, we enrolled 208 consecutive women affected by UI; all underwent a comprehensive history including two validated questionnaires, physical examination, and urodynamic evaluation. Based on BMI, participants were grouped into normal weight, overweight, and obese.
A total of 158 participants completed both questionnaires (76% response rate); 41 (26%) were normal weight, 73 (46%) were overweight, and 44 (28%) were obese. The increasing Urogenital Distress Inventory score had a direct correlation with age (P < 0.01), year of menopause onset (P < 0.05), and BMI (P < 0.01). FSD was diagnosed in 97 women (61%): 31 (32%) with hypoactive sexual desire, 20 (21%) with sexual arousal disorder, 7 (7%) with orgasmic deficiency, and 39 (40%) with sexual pain disorder. BMI greater than 30 kg/m was independently associated with an increased risk of FSD (odds ratio [OR], 2.02) and UI (OR, 2.03). With adjustment for BMI, the OR for FSD was 1.22 for overweight women and 1.56 for obese women, with respect to healthy participants. The total Female Sexual Function Index score correlated with BMI (r = -0.82, P = 0.0001); in particular, arousal (r = -0.82), orgasm (r = -0.72), lubrication (r = -0.61), and satisfaction (r = -0.63, all P < 0.001) showed an inverse correlation with BMI, whereas desire and pain did not.
Increased BMI early in menopause represents a risk both for UI and for sexual dysfunction. Weight control has an essential role in postmenopause and should be considered early in perimenopause to safeguard female quality of life as well as to prevent or improve UI and female sexual dysfunction symptoms.
本研究旨在评估绝经前后患有尿失禁（UI）的女性中，体质量指数（BMI）与女性性功能障碍（FSD）之间的关系。
2005 年至 2008 年，我们纳入了 208 例连续患有 UI 的女性患者；所有患者均接受了详细的病史记录，包括两项经过验证的问卷、体格检查和尿动力学评估。根据 BMI，患者被分为正常体重、超重和肥胖。
共有 158 名患者完成了两份问卷（应答率为 76%）；其中 41 名（26%）为正常体重，73 名（46%）为超重，44 名（28%）为肥胖。尿生殖窘迫问卷评分的增加与年龄（P < 0.01）、绝经起始年份（P < 0.05）和 BMI（P < 0.01）直接相关。97 名女性（61%）被诊断为 FSD：31 名（32%）性欲低下，20 名（21%）性唤起障碍，7 名（7%）性高潮障碍，39 名（40%）性交疼痛障碍。BMI 大于 30 kg/m2 与 FSD（比值比 [OR]，2.02）和 UI（OR，2.03）风险增加独立相关。在调整 BMI 后，与健康参与者相比，超重女性的 FSD 比值比（OR）为 1.22，肥胖女性的 OR 为 1.56。女性性功能指数总分与 BMI 相关（r = -0.82，P = 0.0001）；特别是，唤起（r = -0.82）、高潮（r = -0.72）、润滑（r = -0.61）和满意度（r = -0.63，均 P < 0.001）与 BMI 呈负相关，而欲望和疼痛则没有。
绝经早期 BMI 升高既是 UI 的危险因素，也是性功能障碍的危险因素。体重控制在绝经后具有重要作用，应在绝经前期尽早考虑，以维护女性生活质量，并预防或改善 UI 和女性性功能障碍症状。
