绝经过渡期和绝经早期的性欲：西雅图中年女性健康研究的观察结果。
Sexual desire during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study.
机构信息
Department of Family and Child Nursing, University of Washington, Seattle, Washington 98195-7260, USA.
出版信息
J Womens Health (Larchmt). 2010 Feb;19(2):209-18. doi: 10.1089/jwh.2009.1388.
AIMS
To describe levels of sexual desire across the menopausal transition (MT) and early postmenopause (PM), including effects of age, MT-related factors, health, stress, symptoms (hot flash, sleep, mood), and social opportunity factors.
METHODS
A subset of Seattle Midlife Women's Health Study (SMWHS) participants who provided data during the early reproductive, early and late menopausal transition stages, or postmenopause (n = 286), including menstrual calendars for staging the MT, annual health reports between 1990 and 2005, and morning urine samples assayed for estrone glucuronide (E(1)G), testosterone (T), and follicle-stimulating hormone (FSH) was included. Multilevel modeling using the R program was used to test factors related to sexual desire.
RESULTS
Women experienced a significant decrease in sexual desire during the late MT stage (p < 0.01) and early PM (p < 0.0001). Those with higher urinary E(1)G and T reported significantly higher levels of sexual desire, whereas those with higher FSH levels reported significantly lower sexual desire (p < 0.0001, 0.06, and 0.0002, respectively). Women using hormone therapy also reported higher sexual desire (p = 0.02). Those reporting higher perceived stress reported lower sexual desire (p < 0.0001), but history of sexual abuse did not have a significant effect. Those most troubled by symptoms of hot flashes, fatigue, depressed mood, anxiety, difficulty getting to sleep, early morning awakening, and awakening during the night also reported significantly lower sexual desire (p range from <0.03 to 0.0001), but there was no effect of vaginal dryness. Women with better perceived health reported higher sexual desire (p < 0.0001), and those reporting more exercise and more alcohol intake also reported greater sexual desire (p < 0.0001). Having a partner was associated with lower sexual desire.
CONCLUSIONS
Clinicians working with women traversing the MT should be aware that promoting healthy sexual functioning among midlife women requires consideration of their changing biology as well as ongoing life challenges.
目的
描述绝经过渡（MT）和绝经后早期（PM）期间的性欲水平，包括年龄、MT 相关因素、健康、压力、症状（热潮、睡眠、情绪）和社会机会因素的影响。
方法
西雅图中年女性健康研究（SMWHS）的一部分参与者提供了在早期生殖、早期和晚期绝经过渡阶段或绝经后（n=286）的数据，包括用于分期 MT 的月经周期记录、1990 年至 2005 年期间的年度健康报告，以及用于检测雌酮葡萄糖醛酸（E1G）、睾酮（T）和卵泡刺激素（FSH）的晨尿样本。使用 R 程序进行的多层次建模用于测试与性欲相关的因素。
结果
女性在晚期 MT 阶段（p<0.01）和早期 PM 阶段（p<0.0001）经历了性欲显著下降。尿液中 E1G 和 T 水平较高的女性报告的性欲水平显著较高，而 FSH 水平较高的女性报告的性欲水平显著较低（p<0.0001、0.06 和 0.0002，分别）。使用激素治疗的女性也报告了更高的性欲（p=0.02）。报告压力较大的女性性欲较低（p<0.0001），但性虐待史没有显著影响。受热潮、疲劳、情绪低落、焦虑、入睡困难、清晨觉醒和夜间觉醒等症状困扰最大的女性也报告了性欲显著降低（p 范围从<0.03 到 0.0001），但阴道干燥没有影响。自我感觉健康状况较好的女性性欲较高（p<0.0001），报告运动较多和饮酒较多的女性性欲也较高（p<0.0001）。有伴侣的女性性欲较低。
结论
与处于 MT 过渡阶段的女性合作的临床医生应该意识到，促进中年女性健康的性行为需要考虑她们不断变化的生物学以及持续的生活挑战。
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