Mercan Ramazan, Mercan Sibel, Durmaz Birsen, Sur Haydar, Kilciksiz Can Misel, Kacar Anil Safak, Apaydin Zuhal, Ayhan Cem, Ata Baris
a Koc University School of Medicine , Istanbul , Turkey.
b VKV American Hospital , Istanbul , Turkey.
J Obstet Gynaecol. 2019 Jul;39(5):659-663. doi: 10.1080/01443615.2018.1547694. Epub 2019 Mar 11.
Human papilloma virus infection (HPV) is the most common sexually transmitted disease. It may increase the risk of several cancers, including those of the cervix, vulva, vagina, head and neck. HPV is usually transmitted during sexual intercourse; there are limited data about sexual dysfunction (SD) after infection with this virus. We aimed to measure the incidence of SD in women with HPV. In this study, we evaluated 67 HPV-infected female patients and 66 healthy controls. The Arizona Sexual Experience Scale (ASEX), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Socio Demographic Form were used for evaluation. Gynaecologists and psychiatrists evaluated the participants. Women with HPV were found to have significantly higher Arizona Sexual Experience Scale (ASEX) total scores and ASEX sub scores than the control group in the domains of sexual desire, arousal, genital response, orgasmic experience and their satisfaction from orgasm (p ≤ .05). The study group shows a statistically significant difference in the Beck Depression Inventory (BDI), but Beck Anxiety Inventory (BAI) scores show no significant differences between the experimental and control groups. Our study shows that HPV positivity in female patients is associated with a significant impairment in sexual function and that this impairment is not related to depression or anxiety. Impact statement What is already known on this subject? There are only a few studies concerned with sexual dysfunction in HPV patients. These studies have methodological problems, as they do not rule out the effect of depression on sexual dysfunction. It is very difficult to perform studies on sexual dysfunction and sexually transmitted diseases, because both physicians and patients are reluctant to talk about sexual problems. In the present study, only 6 out of 15 physicians accepted to contribute to the study. Although the physicians gave a questionnaire to more than 400 patients, only 133 of them completed that questionnaire. The most important difficulties in this study was to find enough patients. What do the results of this study add? Depression and sexual dysfunction are frequently seen in HPV patients. Although depression is one of the most common causes of sexual dysfunction, an HPV infection may lead to sexual dysfunction even in the patients without depression. What are the implications of these findings for clinical practice and/or further research? HPV infections may be associated with mental health problems and sexual dysfunction. The gynaecologists and other clinicians working with HPV patients should also evaluate patients psychologically and refer patients to psychiatry if required. The psychiatric problems associated with an HPV infection do not only impair sexual functions, but also may lead to difficulties in social life.
人乳头瘤病毒感染(HPV)是最常见的性传播疾病。它可能会增加多种癌症的发病风险,包括宫颈癌、外阴癌、阴道癌、头颈癌。HPV通常在性交过程中传播;关于感染该病毒后性功能障碍(SD)的数据有限。我们旨在测量感染HPV的女性性功能障碍的发生率。在本研究中,我们评估了67名感染HPV的女性患者和66名健康对照者。使用亚利桑那性体验量表(ASEX)、贝克抑郁量表(BDI)、贝克焦虑量表(BAI)和社会人口学表格进行评估。妇科医生和精神科医生对参与者进行了评估。结果发现,感染HPV的女性在性欲、性唤起、生殖器反应、性高潮体验及其对性高潮的满意度等方面的亚利桑那性体验量表(ASEX)总分及各分项得分均显著高于对照组(p≤0.05)。研究组在贝克抑郁量表(BDI)上存在统计学显著差异,但贝克焦虑量表(BAI)得分在实验组和对照组之间无显著差异。我们的研究表明,女性患者HPV阳性与性功能显著受损有关,且这种损害与抑郁或焦虑无关。影响声明关于该主题已知的信息有哪些?仅有少数研究关注HPV患者的性功能障碍。这些研究存在方法学问题,因为它们没有排除抑郁对性功能障碍的影响。进行性功能障碍和性传播疾病的研究非常困难,因为医生和患者都不愿谈论性问题。在本研究中,15名医生中只有6名同意参与研究。尽管医生向400多名患者发放了问卷,但只有133人完成了问卷。本研究中最重要的困难是找到足够的患者。本研究的结果增加了什么内容?抑郁和性功能障碍在HPV患者中很常见。尽管抑郁是性功能障碍最常见的原因之一,但HPV感染即使在没有抑郁的患者中也可能导致性功能障碍。这些发现对临床实践和/或进一步研究有何意义?HPV感染可能与心理健康问题和性功能障碍有关。治疗HPV患者的妇科医生和其他临床医生也应从心理上评估患者,并在需要时将患者转诊至精神科。与HPV感染相关的精神问题不仅会损害性功能,还可能导致社交生活困难。