Nappi Rossella E, Cucinella Laura, Martella Silvia, Rossi Margherita, Tiranini Lara, Martini Ellis
Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy.
Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Dept of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy.
Maturitas. 2016 Dec;94:87-91. doi: 10.1016/j.maturitas.2016.09.013. Epub 2016 Sep 28.
Female sexual dysfunction (FSD) and quality of life (QOL) are both multidimensional and have a bidirectional relationship across the reproductive life span and beyond. Methodological difficulties exist in estimating the real prevalence of FSD because it is hard to determine the level of distress associated with sexual symptoms in a large-scale survey. Approximately 40-50% of all women report at least one sexual symptom, and some conditions associated with hormonal changes at menopause, such as vulvovaginal atrophy (VVA) and hypoactive sexual desire disorder (HSDD), have a significant impact on sexual function and QOL. Sexual distress peaks at midlife, declines with age and is strongly partner-related. Many postmenopausal women are still sexually active, especially if they are in a stable partnership. Even though sexual functioning is impaired, a variety of psychosocial factors may maintain sexual satisfaction. That being so, health care providers (HCPs) should proactively address sexual symptoms at midlife and in older women, from a balanced perspective. Adequate counselling should be offered. Women with distressing symptoms may benefit from tailored hormonal and non-hormonal therapies, whereas women without distress related to their sexual experiences should not receive any specific treatment.
女性性功能障碍(FSD)和生活质量(QOL)都是多维度的,并且在整个生殖寿命及之后都存在双向关系。在估计FSD的实际患病率时存在方法学上的困难,因为在大规模调查中很难确定与性症状相关的痛苦程度。约40%-50%的女性报告至少有一种性症状,一些与绝经后激素变化相关的情况,如外阴阴道萎缩(VVA)和性欲减退障碍(HSDD),对性功能和生活质量有重大影响。性困扰在中年达到峰值,随年龄下降且与伴侣密切相关。许多绝经后女性仍有性活动,特别是如果她们处于稳定的伴侣关系中。即使性功能受损,多种心理社会因素仍可能维持性满意度。既然如此,医疗保健提供者(HCPs)应从中年及老年女性的平衡视角积极处理性症状,应提供充分的咨询。有困扰症状的女性可能从量身定制的激素和非激素疗法中获益,而无性经历相关困扰的女性不应接受任何特定治疗。