Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
Epidemiology Data Center, University of Pittsburgh, Pittsburgh, PA.
Menopause. 2018 Nov;25(11):1244-1255. doi: 10.1097/GME.0000000000001226.
To examine sexual function in a cohort of Baby Boomer women of diverse racial/ethnic backgrounds; to compare differences between pre-and early perimenopausal women; and to identify sociodemographic, health-related, and psychosocial (including psychological, behavioral, and relationship) factors related to sexual function.
Six domains of sexual function were studied in 3,167 women in the baseline cohort of the Study of Women's Health Across the Nation (SWAN). Participants were 42 to 52 years old, pre-or early perimenopausal, and not using hormones. The study sample included non-Hispanic white, African American, Hispanic, Chinese, and Japanese women.
Early perimenopausal women reported greater pain with intercourse than premenopausal women (P = 0.01), but the two groups did not differ in frequency of sexual intercourse, desire, arousal, or physical or emotional satisfaction. Variables having the greatest association across all outcomes were relationship factors, the perceived importance of sex, attitudes toward aging, and vaginal dryness. Despite controlling for a wide range of variables, we still found ethnic differences for arousal (P < 0.0001), pain (P = 0.03), desire (P < 0.0001), and frequency of sexual intercourse (P = 0.0003). African American women reported higher frequency of sexual intercourse than white women; Hispanic women reported lower physical pleasure and arousal. Chinese women reported more pain and less desire and arousal than the white women, as did the Japanese women, although the only significant difference was for arousal.
Relationship variables, attitudes toward sex and aging, vaginal dryness, and cultural background have a greater impact on most aspects of sexual function than the transition to early perimenopause.
研究不同种族/族裔背景的生育高峰期女性的性功能；比较绝经前和早期绝经期女性之间的差异；并确定与性功能相关的社会人口学、健康相关和心理社会（包括心理、行为和关系）因素。
在全国妇女健康研究（SWAN）的基线队列中，对 3167 名 42 至 52 岁、绝经前或早期绝经且未使用激素的女性进行了 6 个领域的性功能研究。该研究样本包括非西班牙裔白人、非裔美国人、西班牙裔、华裔和日裔女性。
早期绝经的女性报告性交时疼痛比绝经前女性更严重（P = 0.01），但两组在性交频率、性欲、唤起或身体或情感满足方面没有差异。与所有结果相关性最大的变量是关系因素、对性的重视、对衰老的态度以及阴道干燥。尽管控制了广泛的变量，我们仍然发现了种族差异，包括唤起（P < 0.0001）、疼痛（P = 0.03）、性欲（P < 0.0001）和性交频率（P = 0.0003）。非裔美国女性报告的性交频率高于白人女性；西班牙裔女性报告的身体愉悦和唤起较低。与白人女性相比，华裔女性报告的疼痛更多，性欲和唤起更少，而日本女性也是如此，尽管唯一的显著差异是唤起。
关系变量、对性和衰老的态度、阴道干燥和文化背景对性功能的大多数方面的影响大于向早期绝经的过渡。
