Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy; Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
J Sex Med. 2021 Jul;18(7):1217-1229. doi: 10.1016/j.jsxm.2021.04.004. Epub 2021 Jun 5.
Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking.
To investigate the clinical, psychological, and sexual correlates of PA in women with FSD.
A non-selected series of n = 322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regular involvement in PA and its frequency (<1 hour/week: sedentary, 1-3 hours/week: active, 4-6 hours/week: very active, >6 hours/week: extremely active) were investigated with a specific question.
FSDs, including HSDD (Hypoactive sexual desire disorder) and FGAD (Female genital arousal disorder), were diagnosed according to a structured and clinical interview. Participants underwent a physical examination and a clitoral Doppler ultrasound, and were asked to complete the Female Sexual Function Index, Female Sexual Distress Scale-Revised, Body Uneasiness Test, and Middlesex Hospital Questionnaire.
At multivariate analysis, women engaging in PA (67.4%, n = 217) scored significantly higher in several Female Sexual Function Index domains - including desire, arousal and lubrication - and showed lower sexual distress and lower resistance of clitoral arteries, as compared to sedentary women. A significant, inverse association between PA and HSDD was observed. Mediation analysis demonstrated that the negative association between PA and HSDD was partly mediated by body image concerns (Body Uneasiness Test Global severity index), psychopathological symptoms (Middlesex Hospital Questionnaire total score) and sexual distress (Female Sexual Distress Scale-Revised score). These latter 2 factors also partly mediated the association between PA and a reduced risk of FGAD, whilst a lower BMI was a full mediator in the relationship between PA and FGAD. Finally, extreme PA was associated with significantly worse scores in several psychosexual parameters (i,e, sexual satisfaction and histrionic/hysterical symptoms), even compared to a sedentary lifestyle.
Women consulting for FSD may gain benefits on desire, arousal, lubrication and sex-related distress from regular PA; however, physicians should remain alert to the downsides of excessive exercise.
STRENGTHS & LIMITATIONS: The main strength lies in the novelty of the findings. The main limitations are the cross-sectional nature, the clinical setting, the small sample size of the different PA groups, and the use of self-reported instruments for the evaluation of PA.
In women with FSD, PA was associated with better sexual function and clitoral vascularization, lower sexual distress and reduced odds of HSDD and FGAD; the benefits of PA on sexuality were mediated by both psychological and organic determinants; excessive PA was related with a poor overall sexual function and with a low sexual satisfaction. Maseroli E, Rastrelli G, Di Stasi V, et al. Physical Activity and Female Sexual Dysfunction: A Lot Helps, But Not Too Much. J Sex Med 2021;18:1217-1229.
目前针对身体活动（PA）与女性性功能障碍（FSD）之间关系的研究还很缺乏。
旨在研究女性性功能障碍患者中身体活动的临床、心理和性相关因素。
回顾性研究了一组未经选择的 322 例患有 FSD 的绝经前和绝经后患者。通过特定问题调查了她们是否经常参与身体活动及其频率（<1 小时/周：久坐，1-3 小时/周：活跃，4-6 小时/周：非常活跃，>6 小时/周：极度活跃）。
在多变量分析中，参与身体活动（67.4%，n=217）的女性在几个女性性功能指数领域的评分明显更高-包括欲望、唤起和润滑-并且性困扰和阴蒂动脉阻力较低。观察到身体活动与 HSDD 呈显著负相关。中介分析表明，身体活动与 HSDD 之间的负相关部分由身体形象问题（身体不适测试全球严重程度指数）、精神病理学症状（米德尔塞克斯医院问卷总分）和性困扰（女性性困扰量表修订版评分）介导。后两个因素也部分介导了身体活动与 FGAD 风险降低之间的关系，而较低的 BMI 则完全介导了身体活动与 FGAD 之间的关系。最后，极端的身体活动与几个精神心理参数（即性满足和表现性/癔症症状）的评分显著恶化有关，甚至与久坐的生活方式相比也是如此。
患有 FSD 的女性可能会从定期的身体活动中获得欲望、唤起、润滑和与性相关的困扰方面的益处；然而，医生应该对过度运动的副作用保持警惕。
主要优势在于研究结果的新颖性。主要限制在于横断面性质、临床环境、不同身体活动组的样本量小以及使用自我报告的仪器评估身体活动。
在患有 FSD 的女性中，PA 与更好的性功能和阴蒂血管化、更低的性困扰以及降低 HSDD 和 FGAD 的几率相关；PA 对性功能的益处由心理和有机决定因素共同介导；过度的身体活动与整体较差的性功能和较低的性满意度有关。Maseroli E、Rastrelli G、Di Stasi V 等人。《体育活动与女性性功能障碍：适量有益，过度无益》。《性医学杂志》2021 年；18：1217-1229。
