Thomas Holly N, Thurston Rebecca C
University of Pittsburgh, Department of Medicine, United States.
University of Pittsburgh, Department of Psychiatry, United States.
Maturitas. 2016 May;87:49-60. doi: 10.1016/j.maturitas.2016.02.009. Epub 2016 Feb 21.
A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to define sexual function and dysfunction, (b) to present theoretical models of female sexual response, (c) to examine longitudinal studies of how sexual function changes during midlife, and (d) to review treatment options. Four types of female sexual dysfunction are currently recognized: Female Orgasmic Disorder, Female Sexual Interest/Arousal Disorder, Genito-Pelvic Pain/Penetration Disorder, and Substance/Medication-Induced Sexual Dysfunction. However, optimal sexual function transcends the simple absence of dysfunction. A biopsychosocial approach that simultaneously considers physical, psychological, sociocultural, and interpersonal factors is necessary to guide research and clinical care regarding women's sexual function. Most longitudinal studies reveal an association between advancing menopause status and worsening sexual function. Psychosocial variables, such as availability of a partner, relationship quality, and psychological functioning, also play an integral role. Future directions for research should include deepening our understanding of how sexual function changes with aging and developing safe and effective approaches to optimizing women's sexual function with aging. Overall, holistic, biopsychosocial approaches to women's sexual function are necessary to fully understand and treat this key component of midlife women's well-being.
满意的性生活是整体幸福感的重要组成部分，但性功能障碍很常见，尤其是在中年女性中。本综述的目的是：（a）定义性功能和性功能障碍；（b）介绍女性性反应的理论模型；（c）研究关于中年时期性功能如何变化的纵向研究；以及（d）回顾治疗选择。目前公认有四种类型的女性性功能障碍：女性性高潮障碍、女性性兴趣/性唤起障碍、生殖器-盆腔疼痛/插入障碍以及物质/药物所致性功能障碍。然而，最佳性功能不仅仅是简单地没有功能障碍。一种同时考虑身体、心理、社会文化和人际因素的生物心理社会方法对于指导有关女性性功能的研究和临床护理是必要的。大多数纵向研究表明绝经状态进展与性功能恶化之间存在关联。心理社会变量，如伴侣的可及性、关系质量和心理功能，也起着不可或缺的作用。未来的研究方向应包括加深我们对性功能如何随年龄变化的理解，以及开发安全有效的方法来优化女性随年龄增长的性功能。总体而言，对于女性性功能，采用整体的、生物心理社会方法对于充分理解和治疗中年女性幸福感的这一关键组成部分是必要的。
