四十岁以上女性的性抱怨、盆底症状和性困扰。
Sexual complaints, pelvic floor symptoms, and sexual distress in women over forty.
机构信息
Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
J Sex Med. 2010 Nov;7(11):3675-82. doi: 10.1111/j.1743-6109.2010.01955.x.
INTRODUCTION
The American Psychiatric Association recommends considering sexually related personal distress when assessing female sexual dysfunction. Currently, there is little data regarding the impact of sexual complaints on sexual distress.
AIM
To investigate the association between sexual complaints and perceived sexual distress in a population of ambulatory adult women.
METHODS
Using the short forms of the Personal Experiences Questionnaire and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire, we assessed sexual complaints among 305 women seeking outpatient gynecologic care. Depressive symptoms were quantified using the Center for Epidemiologic Studies Depression (CESD) score. Sexual distress was measured using the Female Sexual Distress Scale (FSDS). Using multivariable logistic regression, we compared sexual complaints between distressed and nondistressed women.
MAIN OUTCOME MEASURES
Sexual distress, defined by FSDS score ≥15.
RESULTS
FSDS scores were available for 292/305 participants. Seventy-six (26%) scores reflected distress. Distressed women were more likely to be younger (55.2±1.0 years vs. 56.7±0.8 years, P=0.017); have higher CESD scores (16.6 vs. 9.5, P=0.001); and report decreased arousal (56.8% vs. 25.1%, P=0.001), infrequent orgasm (54% vs. 28.8%, P=0.001), and dyspareunia (39.7% vs. 10.6%, P=0.001). Women with sexual distress were also more likely to report sexual difficulty related to pelvic floor symptoms, including urinary incontinence with sexual activity (9% vs. 1.3%, P=0.005), sexual avoidance due to vaginal prolapse (13.9% vs. 1%, P=0.001), or sexual activity restriction due to fear of urinary incontinence (14.9% vs. 0.5%, P=0.001). After multivariate analysis, sexual distress was significantly associated with dyspareunia (odds ratio [OR] 3.11, P=0.008) and depression score (OR 1.05, P=0.006), and inversely associated with feelings of arousal during sex (OR 0.19, P=0.001).
CONCLUSION
Our results indicate that sexually related personal distress is significantly associated with dyspareunia, depressive symptoms, and decreased arousal during sexual activity. This contributes to our understanding of how sexual complaints may adversely affect women's quality of life.
简介
美国精神病学协会建议在评估女性性功能障碍时考虑与性相关的个人困扰。目前，关于性抱怨对性困扰的影响的数据很少。
目的
调查门诊成年女性人群中性抱怨与感知性困扰之间的关系。
方法
使用个人体验问卷和盆腔器官脱垂/尿失禁性功能问卷的简短形式，我们评估了 305 名寻求妇科门诊护理的女性的性抱怨。使用抑郁症状量表（CESD 评分）量化抑郁症状。使用女性性困扰量表（FSDS）测量性困扰。使用多变量逻辑回归，我们比较了困扰和非困扰女性之间的性抱怨。
主要观察指标
FSDS 评分≥15 表示性困扰。
结果
292/305 名参与者的 FSDS 评分可用。76 名（26%）评分反映了困扰。困扰的女性更年轻（55.2±1.0 岁 vs. 56.7±0.8 岁，P=0.017）；CESD 评分更高（16.6 与 9.5，P=0.001）；并且报告性欲减退（56.8%与 25.1%，P=0.001）、性高潮不频繁（54%与 28.8%，P=0.001）和性交疼痛（39.7%与 10.6%，P=0.001）。有性困扰的女性也更有可能报告与盆底症状相关的性困难，包括与性行为相关的尿失禁（9%与 1.3%，P=0.005）、阴道脱垂导致的性回避（13.9%与 1%，P=0.001）或因害怕尿失禁而限制性行为（14.9%与 0.5%，P=0.001）。多元分析后，性困扰与性交疼痛（比值比[OR]3.11，P=0.008）和抑郁评分（OR 1.05，P=0.006）显著相关，与性唤起呈负相关（OR 0.19，P=0.001）。
结论
我们的研究结果表明，与性相关的个人困扰与性交疼痛、抑郁症状和性活动期间性欲减退显著相关。这有助于我们了解性抱怨如何对女性的生活质量产生不利影响。
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