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生活方式干预改善肥胖和不孕女性的性功能:一项 RCT 的 5 年随访。

A lifestyle intervention improves sexual function of women with obesity and infertility: A 5 year follow-up of a RCT.

机构信息

Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.

出版信息

PLoS One. 2018 Oct 23;13(10):e0205934. doi: 10.1371/journal.pone.0205934. eCollection 2018.

Abstract

BACKGROUND

Obesity and infertility are associated with poorer sexual function. We have previously shown that a lifestyle intervention in women with obesity and infertility reduced weight and improved cardiometabolic health and quality of life, which may positively affect sexual function. We now report on sexual function 5 years after randomization.

METHODS AND FINDINGS

In total 577 women, between 18-39 years of age, with infertility and a BMI ≥29 kg/m2 were randomized to a six-month lifestyle intervention targeting physical activity, diet and behavior modification or prompt infertility care as usual. Intercourse frequency and sexual function were assessed with the McCoy Female Sexuality Questionnaire (MFSQ), 5.4±0.8 years after randomization. 550 women could be approached for the follow-up study, of whom 84 women in the intervention and 93 in the control group completed the MFSQ. Results were adjusted for duration of infertility, polycystic ovary syndrome and whether women were attempting to conceive. The intervention group more often reported having had intercourse in the past 4 weeks compared to the control group (aOR: 2.3 95% CI 0.96 to 5.72). Among women reporting intercourse in the past 4 weeks, the intervention group (n = 75) had intercourse more frequently (6.6±5.8 vs. 4.9±4.0 times; 95% CI 0.10 to 3.40) and had higher scores for vaginal lubrication (16.5±3.0 vs. 15.4±3.5; 95% CI 0.15 to 2.32) and total 'sexual function' score (96.5±14.2 vs. 91.4±12.8; 95% CI 0.84 to 9.35) compared to the control group (n = 72). Sexual interest, satisfaction, orgasm and sex partner scores did not differ statistically between the groups. The intervention effect on sexual function was for 21% mediated by the change in moderate to vigorous physical activity.

CONCLUSION

A six-month lifestyle intervention in women with obesity and infertility led to more frequent intercourse, better vaginal lubrication and overall sexual function 5 years after the intervention. (Trial Registration: NTR1530).

摘要

背景

肥胖和不孕与较差的性功能相关。我们之前的研究表明,对肥胖和不孕的女性进行生活方式干预可以减轻体重,改善心血管代谢健康和生活质量,这可能对性功能产生积极影响。我们现在报告随机分组后 5 年的性功能情况。

方法和发现

共纳入 577 名年龄在 18-39 岁之间、患有不孕且 BMI≥29kg/m2 的女性,随机分为为期 6 个月的生活方式干预组,该组接受针对体力活动、饮食和行为改变的干预,或接受常规的即刻不孕治疗。在随机分组后 5.4±0.8 年,使用 McCoy 女性性功能问卷(MFSQ)评估性交频率和性功能。对随访研究进行了 550 名女性的评估,其中干预组 84 名和对照组 93 名女性完成了 MFSQ 评估。结果根据不孕持续时间、多囊卵巢综合征和女性是否正在尝试受孕进行了调整。与对照组相比,干预组在过去 4 周内更频繁地报告有过性交(aOR:2.3,95%CI 0.96 至 5.72)。在过去 4 周内报告有过性交的女性中,干预组(n=75)性交更频繁(6.6±5.8 次 vs. 4.9±4.0 次;95%CI 0.10 至 3.40),阴道润滑度评分更高(16.5±3.0 分 vs. 15.4±3.5 分;95%CI 0.15 至 2.32),总体“性功能”评分更高(96.5±14.2 分 vs. 91.4±12.8 分;95%CI 0.84 至 9.35),与对照组(n=72)相比。两组间的性兴趣、满意度、性高潮和性伴侣评分没有统计学差异。生活方式干预对性功能的影响有 21%是通过中等强度至高强度体力活动的变化介导的。

结论

对肥胖和不孕的女性进行为期 6 个月的生活方式干预,可导致 5 年后性交更频繁、阴道润滑度更好和整体性功能改善。(试验注册:NTR1530)

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