Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany.
Reprod Sci. 2021 Nov;28(11):3181-3192. doi: 10.1007/s43032-021-00612-4. Epub 2021 Jun 2.
To investigate sexual function in Chinese women with polycystic ovary syndrome (PCOS) and to explore the correlation with clinical and biochemical characteristics. A cross-sectional study was designed in 1000 PCOS women, aged 18-45 years, via the Chinese version of Female Sexual Function Index (FSFI) evaluating sexual function, with additional questions possibly related to sexual life. Clinical and biochemical characteristics likely to affect sexual function were determined, including anthropometric indicators, serum levels of hormones, luteinizing hormone to follicle-stimulating hormone ratio (LH/FSH ratio), prolactin (PRL), total testosterone (TT), free androgen index (FAI), sex-hormone-binding globulin (SHBG), glucose, and lipid metabolism indicators. Nine hundred ten PCOS women participated in the study, 685 patients were included after screening, and 211 were suitable to detect correlations of clinical and biochemical characteristics with sex function parameters. The mean total FSFI score was 24.19 ± 2.8; 79.56% of the women were at risk of female sexual dysfunction (FSD). Women doing regular aerobic exercise and use of contraception had higher FSFI scores, while those with a desire to conceive and clinical signs of hyperandrogenism had lower FSFI scores. There were negative associations of FSFI scores with age and body fat distribution. No significant associations between FSFI scores and hormonal factors (surprisingly including SHBG) were found, except for total testosterone and satisfaction (OR = 0.976, p = 0.002). HOMA-IR was significantly related to reduced desire score (OR = 0.914, p = 0.004) and lubrication score (OR = 0.964, p = 0.044). PCOS was associated with a high risk of FSD (defined according to FSFI) in about 80% of the women in our study, and clinical characteristics play a more important role.
探讨多囊卵巢综合征（PCOS）患者的性功能状况，并分析其与临床和生化特征的相关性。
采用中文版女性性功能指数（FSFI）对 1000 例年龄 18~45 岁的 PCOS 患者进行横断面调查，评估其性功能，同时设置可能与性生活相关的附加问题。记录患者的一般临床和生化特征，包括体质量指数（BMI）、腰臀比（WHR）、激素水平、黄体生成素（LH）/卵泡刺激素（FSH）比值、催乳素（PRL）、总睾酮（TT）、游离雄激素指数（FAI）、性激素结合球蛋白（SHBG）、血糖、血脂代谢指标等，分析这些特征与性功能参数的相关性。
910 例 PCOS 患者参与研究，经过筛选后 685 例纳入分析，211 例患者的临床和生化特征与性功能参数的相关性检测结果具有统计学意义。患者的 FSFI 总评分平均为 24.19±2.8，79.56%的患者存在不同程度的性功能障碍（FSD）。经常进行有氧运动和使用避孕药的患者 FSFI 评分较高，而有生育要求和存在高雄激素血症表现的患者 FSFI 评分较低。FSFI 评分与年龄和体脂分布呈负相关，与激素水平（包括 SHBG）无明显相关性，除 TT 与满意度（OR=0.976，p=0.002）呈负相关外。稳态模型评估的胰岛素抵抗指数（HOMA-IR）与性欲评分（OR=0.914，p=0.004）和润滑评分（OR=0.964，p=0.044）呈负相关。
在本研究中，约 80%的 PCOS 患者存在 FSD（FSFI 定义），临床特征在其中发挥着更重要的作用。
