The North American Menopause Society, Mayfield Heights, OH 44221, USA.
Menopause. 2011 Nov;18(11):1160-71. doi: 10.1097/gme.0b013e3182227ebd.
The aim of this study was to determine the patterns and predictors of sexual activity in the Hormone Therapy (HT) Trials of the Women's Health Initiative (WHI).
Sexual activity questions were administered to 27,347 women ages 50 to 79 years at baseline and at year 1 and to a random 8.6% subsample at years 3 and 6. The associations with demographic and health characteristics were determined.
Sexual activity at baseline was 60.7%, 44.9%, and 28.2% in the 50- to 59-, 60- to 69-, and 70- to 79-year-old age groups, respectively. Most of the participants were satisfied with their current sexual activity (63.2%). Of those dissatisfied, 57% preferred more sexual activity. Vaginal atrophy correlated with sexual inactivity at baseline (P < 0.001). The correlates associated with stopping sexual activity at year 1 included poor/fair self-rated health, lack of satisfaction with quality of life, depression, and loss of partner (P < 0.001). The strongest predictor of sexual activity at year 1 was sexual activity at baseline (odds ratio, 96.71; 95% CI, 81.90-114.20). A subset analysis of women adherent with HT or placebo at years 3 and 6 suggested that HT was associated with a higher percentage of participants reporting sexual activity (P = 0.01).
Most women in the WHI HT Trials were satisfied with their sexual activity. Of those who were dissatisfied, the majority preferred more, rather than less, sexual activity. Vaginal atrophy at baseline correlated with sexual inactivity, and sexual activity at baseline was the strongest identified predictor of sexual activity at year 1. HT use was not predictive of ongoing sexual activity in the intent-to-treat analysis. This report further characterizes the participants in the WHI HT trials and reveals the complexity of factors related to the prevalence of sexual activity and satisfaction.
本研究旨在确定妇女健康倡议（WHI）激素治疗（HT）试验中女性性行为的模式和预测因素。
在基线和第 1 年以及第 3 年和第 6 年随机抽取 8.6%的亚组，对 27347 名年龄在 50 至 79 岁的女性进行性行为问题调查。确定与人口统计学和健康特征的关联。
基线时性行为发生率分别为 50-59 岁、60-69 岁和 70-79 岁年龄组的 60.7%、44.9%和 28.2%。大多数参与者对当前的性行为感到满意（63.2%）。其中 57%对性行为不满意的人更希望有更多的性行为。阴道萎缩与基线时的性行为不活跃相关（P < 0.001）。与第 1 年停止性行为相关的因素包括自评健康状况差/一般、对生活质量不满意、抑郁和伴侣丧失（P < 0.001）。第 1 年性行为的最强预测因素是基线时的性行为（优势比，96.71；95%置信区间，81.90-114.20）。对第 3 年和第 6 年坚持服用 HT 或安慰剂的女性进行亚组分析表明，HT 与报告性行为的参与者比例较高相关（P = 0.01）。
WHI HT 试验中的大多数女性对自己的性行为感到满意。在那些不满意的人中，大多数人更喜欢更多的性行为，而不是更少的性行为。基线时的阴道萎缩与性行为不活跃相关，而基线时的性行为是第 1 年性行为的最强预测因素。在意向治疗分析中，HT 使用与持续性行为无关。本报告进一步描述了 WHI HT 试验的参与者，并揭示了与性行为流行率和满意度相关的复杂因素。
