Sheffield Teaching Hospitals Obstetrics and Gynaecology Unit, Sheffield, South Yorkshire, United Kingdom.
Sheffield Teaching Hospitals Obstetrics and Gynaecology Unit, Sheffield, South Yorkshire, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2021 Dec;267:198-204. doi: 10.1016/j.ejogrb.2021.11.011. Epub 2021 Nov 11.
As life expectancy increases and women are remaining healthy in to older age, sexual function in later life is an increasingly important and relevant topic for both women and clinicians. As a foundation to a wider project examining sexual function in later life, we undertook a systematic review and meta-analysis to investigate sexual frequency and sexual function in women over the age of 60.
A literature search of the AMED (Allied and Complementary Medicine), EMBASE and MEDLINE databases was performed, using search terms including 'sexual function', 'elderly', 'female', 'woman', 'sexuality'. Quality assessment of studies was performed using the Newcastle-Ottawa scale.
There were 10 eligible cross-sectional studies, 4 of which reported sufficient data for meta-analysis. There was a wide range of study sizes from 59 to 27, 500 participants. Each study utilised a different tool for assessing sexual function. The largest study reported that up to 73% of women remain sexually active in later life [1]. Other studies documented decreasing sexual desire with age and an association between enjoyment of sex in the past with good sexual function in the present. Meta-analysis was performed with 4 studies comparing women over the age of 60 with women under 60. This demonstrated a significant decrease in the proportion of women who were sexually active over the age of 60 (SMD 9.73, [4.69, 14.78], p = 0.0002). There were non-significant trends towards poorer sexual function (p = 0.06) and decreased interest in sex (p = 0.19) in older age.
Female sexual activity declines significantly with age and there is a non-significant association with poorer sexual function and decreasing sexual desire. Multiple biopsychosocial factors can impact on sexual function however, information relating to specific areas of sexual dysfunction with aging is sparse. This systematic review will inform a large-scale primary research project examining sexual function and dysfunction and impact on quality of life in older women, specifically in the context of women with pelvic floor disorders, in order to gain further insight and enhance clinical and holistic approaches to assessment and management.
随着预期寿命的延长和女性在老年时保持健康，晚年的性功能对女性和临床医生来说都是一个日益重要和相关的话题。作为更广泛地研究晚年性功能的项目的基础，我们进行了系统的综述和荟萃分析，以调查 60 岁以上女性的性频率和性功能。
使用包括“性功能”、“老年人”、“女性”、“妇女”、“性行为”在内的搜索词，对 AMED（补充和替代医学）、EMBASE 和 MEDLINE 数据库进行了文献检索。使用纽卡斯尔-渥太华量表对研究进行质量评估。
有 10 项合格的横断面研究，其中 4 项报告了足够的数据进行荟萃分析。研究规模从 59 到 27，500 名参与者不等。每个研究都使用了不同的工具来评估性功能。最大的研究报告称，多达 73%的女性在晚年仍保持性行为活跃[1]。其他研究记录了随着年龄的增长性欲下降，以及过去享受性与现在良好的性功能之间的关联。对 4 项比较 60 岁以上女性与 60 岁以下女性的研究进行了荟萃分析。这表明，60 岁以上女性中性行为活跃的比例显著下降（SMD 9.73，[4.69，14.78]，p=0.0002）。年龄较大时，性功能较差（p=0.06）和性兴趣降低（p=0.19）呈非显著趋势。
女性的性活动随着年龄的增长而显著下降，并且与性功能较差和性欲下降有非显著关联。多个生物心理社会因素会影响性功能，但是与衰老相关的特定性障碍的信息很少。本系统综述将为一个大型的原发性研究项目提供信息，该项目将调查老年女性的性功能和性功能障碍以及对生活质量的影响，特别是在患有盆底疾病的女性中，以进一步深入了解，并增强对评估和管理的临床和整体方法。
