Graziottin Alessandra
San Raffaele Resnati Hospital, Center for Gynecology and Medical Sexology, Via E. Panzacchi 6, 20123 Milan, Italy.
Womens Health (Lond). 2007 Jul;3(4):455-74. doi: 10.2217/17455057.3.4.455.
Premature menopause, that is, menopause - spontaneous or iatrogenic - occurring at or before the age of 40 years, affects sexual identity, sexual function and sexual relationships. The woman's health, wellbeing and achievement of life's goals may be variably impaired. Factors modulating the individual's sexual outcome after premature menopause include: etiological heterogeneity of premature menopause and associated medical and sexual comorbidities; psychosexual vulnerability to premature menopause and associated infertility in survivors of childhood and adolescent cancers; impact of premature menopause on women's sexual identity, sexual function - particularly the biological basis of desire, arousal, orgasm and vaginal receptivity - and sexual relationships; partner-related factors; fertility issues; and preventive/therapeutic measures. Hormone therapy is indicated but long-term safety data are lacking. An interdisciplinary medical and psychosexual approach comprises appropriate counseling, fertility protection, when feasible, individualized hormone therapy and specific psychosexual treatment(s). Further research on fertility protection and the safety of long-term hormone therapy after premature menopause is needed.
过早绝经，即40岁及以前发生的自然或医源性绝经，会影响性身份、性功能和性关系。女性的健康、幸福感及生活目标的实现可能会受到不同程度的损害。调节过早绝经后个体性结局的因素包括：过早绝经的病因异质性及相关的医学和性合并症；儿童期和青少年期癌症幸存者对过早绝经及相关不孕的心理性易损性；过早绝经对女性性身份、性功能（尤其是性欲、性唤起、性高潮和阴道容纳性的生物学基础）及性关系的影响；伴侣相关因素；生育问题；以及预防/治疗措施。激素治疗是有指征的，但缺乏长期安全性数据。跨学科的医学和心理性方法包括适当的咨询、可行时的生育保护、个体化激素治疗及特定的心理性治疗。需要对过早绝经后的生育保护及长期激素治疗的安全性进行进一步研究。
