Research Center for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy.
Division of Gynecology and Obstetrics, Department of Medicine and Surgery, "SS. Giovanni di Dio e Ruggi d'Aragona - Schola Medica Salernitana", University of Salerno Hospital, Salerno, Italy.
J Obstet Gynaecol. 2021 Feb;41(2):290-297. doi: 10.1080/01443615.2020.1832973. Epub 2021 Jan 12.
The aim of current study was to estimate the impact of vulvovaginal atrophy (VVA) on sexual function in a clinical population of Italian postmenopausal women. Women aged 45-75 years with at least one VVA symptom completed three questionnaires: Day-to-Day Impact of Vaginal Aging (DIVA), Female Sexual Function Index (FSFI) and Female Sexual Distress Scale revised (FSDS-R). A gynaecological examination was performed for VVA confirmation. Among the 1,066 evaluable patients, VVA was confirmed in around 90% of the sample. Sexual function impairment was significantly higher in patients with confirmed VVA as observed by significant differences in the sexual function component of the DIVA questionnaire ( = .014), the FSDS-R ( < .0005), and the FSFI ( < .0005), as well as for all the FSFI subdomains: desire ( < .0005), arousal ( < .0005), lubrication ( < .0005), orgasm ( < .0005), satisfaction ( < .0005) and pain ( < .0005). Significant impairment of sexual function was demonstrated in Italian postmenopausal women who were clinically confirmed with signs of VVA through gynaecological examination.IMPACT STATEMENT At least half of postmenopausal women report VVA associated symptoms with significant impact on sexual function and ultimately on sexual activity. As compared with patients without confirmed VVA, the negative impact on sexual function was significantly higher in patients with confirmed VVA. This difference was observed for the sexual function component (DIVA-C) of the DIVA questionnaire, for the overall FSDS-R result, and for the overall FSFI score, as well as for all the FSFI subdomains (desire, arousal, lubrication, orgasm, satisfaction and pain). An impairment of sexual function is significantly associated with VVA diagnosis in Italian post-menopausal women, especially when diagnosis was objectively confirmed by clinical signs of VVA visible in the gynaecological examination. In addition, this study demonstrates that inquiring about VVA using a structured questionnaire may increase the diagnosis of VVA related changes in sexual function.
本研究旨在评估意大利绝经后女性中阴道萎缩（VA）对性功能的影响。45-75 岁之间至少有一个 VA 症状的女性完成了三个问卷：阴道衰老日常影响（DIVA）、女性性功能指数（FSFI）和女性性功能障碍修订量表（FSDS-R）。对 VA 进行了妇科检查以确认。在 1066 名可评估的患者中，约 90%的样本确认了 VA。通过 DIVA 问卷的性功能部分（ = .014）、FSDS-R（ < .0005）和 FSFI（ < .0005），以及所有 FSFI 子领域（性欲、唤起、润滑、性高潮、满意度和疼痛）的显著差异，发现患有 VA 的患者性功能障碍显著更高。在意大利绝经后女性中，通过妇科检查证实存在 VA 体征的患者中，性功能明显受损。
意大利绝经后女性 VA 相关症状发生率较高，对性功能有显著影响，最终对性行为有影响。与未确诊 VA 的患者相比，确诊 VA 的患者性功能受损程度显著更高。这种差异在 DIVA 问卷的性功能部分（DIVA-C）、FSDS-R 总体结果和 FSFI 总分以及 FSFI 所有子领域（性欲、唤起、润滑、性高潮、满意度和疼痛）中均观察到。性功能障碍与意大利绝经后女性的 VA 诊断显著相关，尤其是当 VA 的临床体征在妇科检查中可见时，VA 的诊断得到客观证实。此外，本研究表明，使用结构化问卷询问 VA 可能会增加 VA 相关性功能改变的诊断。
