Johansen Nora, Liavaag Astrid H, Mørkrid Lars, Michelsen Trond M
Department of Gynecology, Sørlandet Hospital Arendal, Arendal, Norway.
Department of Gynecology, Sørlandet Hospital Arendal, Arendal, Norway.
Sex Med. 2018 Jun;6(2):143-153. doi: 10.1016/j.esxm.2018.02.002. Epub 2018 Apr 7.
Women after risk-reducing salpingo-oophorectomy (RRSO) can have impaired sexual functioning, but whether there is an association between hormone levels and sexual functioning is unclear.
To determine whether hormone levels are associated with sexual functioning in women after RRSO.
This is a retrospective cohort study of 198 sexually active and 91 inactive women after RRSO. Participants completed the Sexual Activity Questionnaire, questionnaires concerning hormone replacement therapy (HRT), quality of life, care from partner, body image, and comorbidity and provided blood samples. Associations between sexual functioning scores and covariates were examined by linear regression. Variables associated with sexual activity were examined by logistic regression.
Associations with sexual pleasure and sexual discomfort scores were expressed by multivariable regression coefficients and associations with sexual activity were expressed by odds ratios.
None of the hormone levels were associated with sexual pleasure in contrast to age (P = .032), current use of systemic HRT (P = .002), and more care form partner (P < .001). Increased free androgen index (P = .016), more care from partner (P = .017), systemic HRT (P = .002), and no history of cardiovascular disease (P = .001) were associated with less sexual discomfort. The odds ratio of being sexually active increased with younger age, no breast cancer, better quality of life, and more care from partner.
Our results indicate that other factors than hormone levels are important for sexual functioning, although systemic HRT can have a positive impact on sexual functioning in women who have undergone RRSO. Testosterone therapy could improve women's sexual functioning after RRSO; however, the inverse association between free androgen levels and sexual discomfort should be addressed in future studies. Johansen N, Liavaag AH, Mørkird L, Michelsen TM. Hormone Levels and Sexual Functioning After Risk-Reducing Salpingo-Oophorectomy. Sex Med 2018;6:143-153.
进行降低风险的输卵管卵巢切除术（RRSO）后的女性可能存在性功能障碍，但激素水平与性功能之间是否存在关联尚不清楚。
确定RRSO术后女性的激素水平与性功能是否相关。
这是一项对198名有性行为和91名无性行为的RRSO术后女性进行的回顾性队列研究。参与者完成了性活动问卷、关于激素替代疗法（HRT）的问卷、生活质量问卷、伴侣关怀问卷、身体意象问卷以及合并症问卷，并提供了血液样本。通过线性回归分析性功能评分与协变量之间的关联。通过逻辑回归分析与性活动相关的变量。
多变量回归系数表示与性快感和性不适评分的关联，比值比表示与性活动的关联。
与年龄（P = 0.032）、当前使用全身性HRT（P = 0.002）以及更多来自伴侣的关怀（P < 0.001）相比，激素水平与性快感均无关联。游离雄激素指数升高（P = 0.016）、更多来自伴侣的关怀（P = 0.017）、全身性HRT（P = 0.002）以及无心血管疾病史（P = 0.001）与较少的性不适相关。性活跃的比值比随年龄较小、无乳腺癌、生活质量较好以及更多来自伴侣的关怀而增加。
我们的结果表明，尽管全身性HRT对RRSO术后女性的性功能可能有积极影响，但激素水平以外的其他因素对性功能也很重要。睾酮治疗可能改善RRSO术后女性的性功能；然而，游离雄激素水平与性不适之间的负相关关系应在未来研究中加以探讨。约翰森N，利亚瓦格AH，莫尔基德L，米克尔森TM。降低风险的输卵管卵巢切除术后激素水平与性功能。性医学2018；6：143 - 153。
