Maseroli E, Fanni E, Mannucci E, Fambrini M, Jannini E A, Maggi M, Vignozzi L
Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
Diabetes Agency, Careggi Hospital, Florence, Italy.
Andrology. 2016 Sep;4(5):911-20. doi: 10.1111/andr.12224. Epub 2016 Jul 13.
It has been generally assumed that partner's erectile dysfunction, premature, and delayed ejaculation play a significant role in determining female sexual dysfunction (FSD). This study aimed to evaluate the role of the male partner's sexual function, as perceived by women, in determining FSD. A consecutive series of 156 heterosexual women consulting our clinic for FSD was retrospectively studied. All patients underwent a structured interview and completed the Female Sexual Function Index (FSFI). FSFI total score decreased as a function of partner's age, conflicts within the couple, relationship without cohabitation and the habit of engaging in intercourse to please the partner; FSFI total score increased as a function of frequency of intercourse, attempts to conceive and fertility-focused intercourse. FSFI total score showed a negative, stepwise correlation with partner's perceived hypoactive sexual desire (HSD) (r = -0.327; p < 0.0001), whereas no significant correlation was found between FSFI and erectile dysfunction, premature and delayed ejaculation. In an age-adjusted model, partner's HSD was negatively related to FSFI total score (Wald = 9.196, p = 0.002), arousal (Wald = 7.893, p = 0.005), lubrication (Wald = 5.042, p = 0.025), orgasm (Wald = 9.293, p = 0.002), satisfaction (Wald = 12.764, p < 0.0001), and pain (Wald = 6.492, p = 0.011) domains. Partner's HSD was also significantly associated with somatized anxiety, low frequency of intercourse, low partner's care for the patient's sexual pleasure, and with a higher frequency of masturbation, even after adjusting for age. In patients not reporting any reduction in libido, FSFI total score was significantly lower when their partner's libido was low (p = 0.041); the correlation disappeared if the patient also experienced HSD. In conclusion, the presence of erectile dysfunction, premature, and delayed ejaculation of the partner may not act as a primary contributing factor to FSD, as determined by FSFI scores; conversely, women's sexuality seems to be mostly impaired by the perceived reduction in their partner's sexual interest.
人们普遍认为伴侣的勃起功能障碍、早泄和射精延迟在女性性功能障碍（FSD）的发生中起重要作用。本研究旨在评估女性所感知的男性伴侣性功能在FSD发生中的作用。对连续156名因FSD前来我院就诊的异性恋女性进行了回顾性研究。所有患者均接受了结构化访谈并完成了女性性功能指数（FSFI）。FSFI总分随伴侣年龄、夫妻间冲突、非同居关系以及为取悦伴侣而进行性交的习惯而降低；FSFI总分随性交频率、受孕尝试和以生育为重点的性交而增加。FSFI总分与伴侣感知到的性欲减退（HSD）呈负向逐步相关（r = -0.327；p < 0.0001），而FSFI与勃起功能障碍、早泄和射精延迟之间未发现显著相关性。在年龄校正模型中，伴侣的HSD与FSFI总分（Wald = 9.196，p = 0.002）、性唤起（Wald = 7.893，p = 0.005）、润滑（Wald = 5.042，p = 0.025）、性高潮（Wald = 9.293，p = 0.002）、满意度（Wald = 12.764，p < 0.0001）和疼痛（Wald = 6.492，p = 0.011）领域呈负相关。即使在调整年龄后，伴侣的HSD也与躯体化焦虑、性交频率低、伴侣对患者性快感的关注度低以及自慰频率高显著相关。在未报告性欲减退的患者中，当伴侣性欲低时，FSFI总分显著降低（p = 0.041）；如果患者也存在HSD，则这种相关性消失。总之，根据FSFI评分，伴侣存在勃起功能障碍、早泄和射精延迟可能并非FSD的主要促成因素；相反，女性的性功能似乎主要受到其伴侣性兴趣下降的影响。
