Urology Department, Curry Cabral Hospital, Lisbon, Portugal.
J Sex Med. 2013 Feb;10(2):430-8. doi: 10.1111/jsm.12013. Epub 2012 Dec 5.
Female sexual dysfunction (FSD) in peripheral polyneuropathies besides diabetes mellitus is still a poorly studied subject. Little is known about sexual function in women with amyloidosis, Guillain-Barré syndrome, or porphyria. Even for the world's most common peripheral polyneuropathies such as diabetes mellitus, knowledge and consensus are still lacking. Familial amyloidotic polyneuropathy (FAP) is the most common cause of genetic systemic amyloidosis, with neurological clinical manifestations similar to diabetes mellitus. Until today, no study on the sexual function of these young female patients has been published.
To evaluate FSD in female FAP patients and to compare the results with those of healthy, non-FAP females.
A questionnaire-based, observational study comprising 94 nonmenopausal women with a sexual partner (51 FAP and 43 non-FAP as the control group) was conducted. The Female Sexual Function Index (FSFI)--Portuguese-validated version was used to assess FSD.
Total and subscales scores of the FSFI.
FSD was reported by 42% (95% confidence intervals [CI] 28.3-55.7) of FAP patients compared to 12% of healthy controls. Of all the FAP patients, 39.2% reported problems with desire (95% CI 25.6-52.4), 72.5% reported problems with arousal (95% CI 60.2-84.8), 68% reported lubrication problems (95% CI 55.1-80.9), 62% reported orgasm problems (95% CI 48.5-75.5), 39.2% experienced pain (95% CI, 25.8-52.6), and 49% experienced sexual dissatisfaction (95% CI, 35.3-62.7). Even after multiple logistic regression analysis, FAP is associated with sexual dysfunction in women (OR 4.3, 95% CI 1.2-15.5, P < 0.03), and the affected domains are desire (OR 5.1, 95% CI 1.3-19.7, P < 0.02), arousal (OR 4.7, 95% CI 1.5-14.1, P < 0.007), orgasm (OR 5, 95% CI 1.6-16, P < 0.007), and sexual satisfaction (OR 4.8, 95% CI 1.4-16.9, P < 0.02). Only the use of medication with potential for sexual dysfunction was found as a significant predictor of orgasm disorder (OR 4.2, 95% CI 1.1-15.6, P < 0.03), as did age for sexual dissatisfaction (OR 1.1, 95% CI 1.0-1.2, P < 0.04).
FAP as a peripheral polyneuropathy results in FSD, presenting a risk factor four times greater and related to disease severity in terms of desire, arousal, and orgasm disorders, as well as sexual dissatisfaction.
除了糖尿病之外，女性性功能障碍（FSD）在周围性多发性神经病中仍然是一个研究不足的课题。对于患有淀粉样变性、吉兰-巴雷综合征或卟啉症的女性的性功能，人们知之甚少。即使对于世界上最常见的周围性多发性神经病，如糖尿病，知识和共识仍然缺乏。家族性淀粉样变性多发性神经病（FAP）是遗传性系统性淀粉样变性最常见的原因，其神经临床表现与糖尿病相似。直到今天，还没有关于这些年轻女性患者性功能的研究发表。
评估女性 FAP 患者的 FSD，并将结果与健康的非 FAP 女性进行比较。
进行了一项基于问卷的观察性研究，共纳入 94 名有性伴侣的非绝经期女性（51 名 FAP 和 43 名非 FAP 作为对照组）。使用经过验证的葡萄牙版女性性功能指数（FSFI）评估 FSD。
FSFI 的总分和各分量表评分。
与健康对照组的 12%相比，FAP 患者中报告 FSD 的比例为 42%（95%置信区间 [CI] 28.3-55.7）。在所有 FAP 患者中，39.2%报告存在性欲问题（95%CI 25.6-52.4），72.5%报告存在唤起问题（95%CI 60.2-84.8），68%报告存在润滑问题（95%CI 55.1-80.9），62%报告存在性高潮问题（95%CI 48.5-75.5），39.2%报告存在疼痛（95%CI，25.8-52.6），49%报告存在性不满（95%CI，35.3-62.7）。即使经过多变量逻辑回归分析，FAP 与女性的性功能障碍相关（比值比 4.3，95%CI 1.2-15.5，P < 0.03），受影响的领域包括性欲（比值比 5.1，95%CI 1.3-19.7，P < 0.02）、唤起（比值比 4.7，95%CI 1.5-14.1，P < 0.007）、性高潮（比值比 5，95%CI 1.6-16，P < 0.007）和性满意度（比值比 4.8，95%CI 1.4-16.9，P < 0.02）。只有发现具有潜在性功能障碍的药物使用被认为是性高潮障碍的显著预测因素（比值比 4.2，95%CI 1.1-15.6，P < 0.03），年龄也是性不满的显著预测因素（比值比 1.1，95%CI 1.0-1.2，P < 0.04）。
FAP 作为一种周围性多发性神经病，会导致 FSD，其风险因素增加四倍，并与疾病严重程度相关，表现为性欲、唤起和性高潮障碍以及性不满。
