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绝经后女性性功能障碍的治疗选择。

Therapeutic options for postmenopausal female sexual dysfunction.

机构信息

Gynaecology Research Unit, Victoria Building, University Hospitals of Leicester, Leicester, UK.

出版信息

Climacteric. 2010 Apr;13(2):103-20. doi: 10.3109/13697130903437615.

Abstract

BACKGROUND

Female sexual dysfunction (FSD) is a multidimensional problem combining biological, psychological and interpersonal elements of multiple etiologies. Menopause-related sexual dysfunction may not be reversible without therapy. Hormonal deficiency does not usually decrease in severity over time. Many options are available for the successful treatment of postmenopausal FSD.

OBJECTIVE

To review the pharmacological and non-pharmacological therapies available for postmenopausal FSD, focusing on practical recommendations for managing postmenopausal women with sexual complaints, through a literature review of the most relevant publications in this field. PSYCHOSOCIAL THERAPY: This type of therapy (basic counselling, physiotherapy and psychosexual intervention) is considered an adaptable step-by-step approach for diagnostic and therapeutic strategies, normally combined with biomedical interventions to provide optimal outcomes. PHARMACOLOGICAL THERAPY: For postmenopausal FSD, many interventional options are now available, including hormonal therapies such as estrogens, testosterone, combined estrogen/testosterone, tibolone and dehydroepiandrosterone.

CONCLUSIONS

Menopause and its transition represent significant risk factors for the development of sexual dysfunction. FSD impacts greatly on a patient's quality of life. Consequently, it is receiving more attention thanks to the development of effective treatments. Non-pharmacological approaches should be used first, focusing on lifestyle and psychosexual therapy. If required, proven effective hormonal and non-hormonal therapeutic options are available.

摘要

背景

女性性功能障碍(FSD)是一个多维度的问题,结合了多种病因的生物、心理和人际因素。绝经相关的性功能障碍如果没有治疗可能是不可逆转的。激素缺乏通常不会随着时间的推移而加重。有许多选择可用于成功治疗绝经后 FSD。

目的

通过对该领域最相关出版物的文献回顾,回顾绝经后 FSD 可用的药理学和非药理学治疗方法,重点介绍针对有性抱怨的绝经后妇女管理的实用建议。心理社会治疗:这种治疗类型(基础咨询、物理治疗和性心理干预)被认为是一种适应性的逐步诊断和治疗策略,通常与生物医学干预相结合,以提供最佳结果。药物治疗:对于绝经后 FSD,现在有许多干预选择,包括激素治疗,如雌激素、睾酮、雌/睾酮联合、替勃龙和脱氢表雄酮。

结论

绝经及其过渡是性功能障碍发展的重要危险因素。FSD 极大地影响了患者的生活质量。因此,由于有效的治疗方法的发展,它受到了更多的关注。应首先使用非药物方法,重点关注生活方式和性心理治疗。如果需要,还可以使用经过验证的有效激素和非激素治疗选择。

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