Shionogi Europe, London, UK.
Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy.
Menopause. 2020 Apr;27(4):423-429. doi: 10.1097/GME.0000000000001496.
To estimate the impact of vulvovaginal atrophy (VVA) on sexual function in a clinical population of postmenopausal women.
Women 45 to 75 years old and more than 12 months after the last menstruation, who attended menopausal/gynecological centers in Italy and Spain, were included. Women with at least one VVA symptom completed the following questionnaires: Day-to-Day Impact of Vaginal Aging (DIVA), Female Sexual Function Index (FSFI), and Female Sexual Distress Scale revised (FSDS-R). A physical gynecological examination was performed to confirm the VVA diagnosis. Data were analyzed by chi-square and Student's t tests.
In all, 2,160 evaluable women were included in the study. VVA was confirmed in 90% of the included participants. The negative impact on sexual function was significantly higher in women with than in women without confirmed VVA, as evaluated with the sexual function component (DIVA-C) of the DIVA questionnaire (P = 0.013). Statistically significant differences (P < 0.0005) were also detected in the scores of overall FSDS-R, the overall FSFI, and of all the FSFI subdomains (desire, arousal, lubrication, orgasm, satisfaction, and pain).
For postmenopausal women with at least one VVA symptom, the presence of physician-confirmed VVA is associated with significant impaired sexual function, as shown by unadjusted analyses. Given the impact on quality of life and the prevalence of VVA, further research to improve and reduce VVA is warranted.
评估绝经后妇女临床人群中阴道萎缩(VA)对性功能的影响。
纳入年龄在 45 至 75 岁之间且绝经后 12 个月以上、在意大利和西班牙的绝经/妇科中心就诊的女性。至少有一个 VA 症状的女性完成了以下问卷:阴道衰老日常影响(DIVA)、女性性功能指数(FSFI)和修订后的女性性困扰量表(FSDS-R)。进行妇科体格检查以确认 VA 诊断。采用卡方检验和 Student's t 检验进行数据分析。
共有 2160 名可评估的女性纳入研究。90%的纳入参与者被确诊为 VA。VA 确诊的女性性功能障碍影响明显高于未确诊 VA 的女性,这在 DIVA 问卷的性功能部分(DIVA-C)评估中得到了证实(P=0.013)。在整体 FSDS-R、整体 FSFI 和所有 FSFI 子领域(欲望、唤起、润滑、高潮、满意度和疼痛)的评分中也检测到了统计学上的显著差异(P<0.0005)。
对于至少有一个 VA 症状的绝经后女性,经医生确认的 VA 存在与明显受损的性功能相关,这是未经调整分析的结果。鉴于 VA 对生活质量的影响和其普遍性,需要进一步研究以改善和减少 VA。