Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
Maturitas. 2022 Dec;166:50-57. doi: 10.1016/j.maturitas.2022.08.010. Epub 2022 Aug 28.
Female sexual function relies on a complex interplay of physical, psychosocial, and neurobiological factors. Over the last decades, increasing attention has been paid to the influence of personality traits on general health and many aspects of quality of life, including sexuality.
To assess whether dimensions of the personality are related to the domains of sexual function (desire, arousal, lubrication, orgasm, satisfaction, and pain) in symptomatic postmenopausal women. Mood was also investigated to explore its association with female sexual dysfunction (FSD).
Validated questionnaires to assess sexual function [the Female Sexual Functioning Index (FSFI)], mood [the State-Anxiety Inventory (STAI), and Zung Self Rating Depression Scale (SDS)], and personality traits [the Tridimensional Personality Questionnaire (TPQ)] were filled in by 130 early postmenopausal women experiencing hot flushes (≥30/week).
61.5 % (n = 80) of the women had an FSFI total score lower than 26.55, the standard cut-off for FSD. A clinical state of anxiety was present in 53.8 % (n = 70), whereas only 12.3 % (n = 16) showed clinically relevant depressive symptoms. According to the FSFI cut-off score, women with sexual disorders had statistically significantly higher levels of anxiety, depression (p < 0.001 for both), and harm avoidance (HA) (p = 0.004) than women without such disorders. Significantly higher levels of anxiety were found in women in the lower quartile (LQ) of the distribution of the total FSFI score than in women in both the interquartile range (IQR) and in the upper quartile (UQ) (p < 0.05). Moreover, women in the UQ had a lower grade of depression and HA than others (p < 0.05). The Sobel test showed that the personality trait HA significantly mediated the relationship between anxiety and FSFI total score (Z = -2.19, p < 0.05) and between depression and FSFI total score (Z = -2.35, p < 0.05).
The present data suggest the personality trait HA is relevant to sexual function and mediates the impact of mood on FSD in symptomatic menopausal women. In clinical practice, the use of validated psychometric tools for mood screening is useful to establish appropriate diagnosis and treatment of sexual disorders in menopausal women. Moreover, the assessment of personality traits could provide additional information that directs clinicians towards an increasingly tailored and multidimensional treatment of FSD.
女性性功能依赖于生理、心理社会和神经生物学因素的复杂相互作用。在过去的几十年中，人们越来越关注人格特质对整体健康和生活质量（包括性生活）的许多方面的影响。
评估人格特质维度与有症状的绝经后妇女的性功能（欲望、唤起、润滑、高潮、满足和疼痛）领域是否相关。还研究了情绪，以探索其与女性性功能障碍（FSD）的关系。
通过 130 名经历热潮（≥30/周）的早期绝经后女性填写了经过验证的性功能评估问卷[女性性功能指数（FSFI）]、情绪[状态焦虑量表（STAI）和 Zung 自评抑郁量表（SDS）]和人格特质问卷[三维人格问卷（TPQ）]。
61.5%（n=80）的女性 FSFI 总分低于 26.55，这是 FSD 的标准截断值。53.8%（n=70）的女性出现临床焦虑状态，而只有 12.3%（n=16）的女性出现临床相关的抑郁症状。根据 FSFI 截断值，有性功能障碍的女性焦虑和抑郁水平显著高于无性功能障碍的女性（均为 p<0.001），而回避型人格特质（HA）水平也显著高于无性功能障碍的女性（p=0.004）。在 FSFI 总分分布的下四分位数（LQ）中，女性的焦虑水平显著高于在四分位距（IQR）和上四分位数（UQ）中的女性（p<0.05）。此外，UQ 中的女性抑郁和 HA 程度较低（p<0.05）。Sobel 检验表明，人格特质 HA 显著中介了焦虑与 FSFI 总分之间的关系（Z=-2.19，p<0.05）和抑郁与 FSFI 总分之间的关系（Z=-2.35，p<0.05）。
本研究数据表明，回避型人格特质与性功能相关，并中介了情绪对有症状的绝经后女性 FSD 的影响。在临床实践中，使用经过验证的心理测量工具进行情绪筛查有助于对绝经后女性的性功能障碍进行适当的诊断和治疗。此外，对人格特质的评估可以提供额外的信息，使临床医生能够针对 FSD 进行更具针对性和多维的治疗。
