Bachmann G A
Division of General Obstetrics & Gynecology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, USA.
Int J Fertil Menopausal Stud. 1995;40 Suppl 1:16-22.
Menopause is associated with anatomical, physiological and psychological changes that often influence sexuality in the aging female. The decreased estrogen levels have a multitude of effects on sexual function, including decreased support of female pelvis, loss of ability to adequately lubricate the urogenital tissue, and changes in body configuration. This situation is aggravated by the alterations in the skin, breasts, muscles and skeleton caused by estrogen loss. For many women, these changes translate into a poorer self-image, diminution of self-esteem and, eventually, a loss of sexual desire. Societal expectations also have a negative impact on sexuality, as most cultures still believe that older women become sexually retired. Although this attitude is changing, cross-sectional studies still show that there are negative sexuality changes associated with menopause and that postmenopausal women note a loss of sexual desire. Age and relationship status are also important correlates of sexual activity and sexual satisfaction. With increasing age, the frequency of most types of sexual activity decreases and sexual dysfunctions increase. Urogenital atrophy due to loss of estrogen is one of the most important contributors to the decline in sexual activity with the menopause. Partner availability and partner function are important contributors as well to the decline of sexual activity, since older men, like older women, often have sexual dysfunctions. Overall, decreased sexual desire and loss of vaginal lubrication in the female and erectile difficulties in the male, or absence of a partner, are commonly reported causes of increasing sexual difficulties for the older female. Hormone replacement therapy not only ameliorates the local anatomic and physiologic changes, but also may have positive psychological benefits.(ABSTRACT TRUNCATED AT 250 WORDS)
更年期与解剖学、生理学和心理学变化相关，这些变化常常影响老年女性的性功能。雌激素水平下降对性功能有多种影响，包括对女性骨盆支撑力下降、泌尿生殖组织充分润滑能力丧失以及身体形态改变。雌激素流失引起的皮肤、乳房、肌肉和骨骼变化使这种情况更加严重。对许多女性来说，这些变化导致自我形象变差、自尊心降低，最终性欲丧失。社会期望也对性功能有负面影响，因为大多数文化仍然认为老年女性不再有性需求。尽管这种观念正在改变，但横断面研究仍表明，更年期与负面的性功能变化有关，绝经后女性表示性欲丧失。年龄和恋爱状况也是性活动和性满意度的重要相关因素。随着年龄增长，大多数类型性活动的频率降低，性功能障碍增加。雌激素流失导致的泌尿生殖系统萎缩是更年期后性活动减少的最重要原因之一。伴侣的可获得性和伴侣的性功能也是性活动减少的重要原因，因为老年男性和老年女性一样，也常有性功能障碍。总体而言，女性性欲降低、阴道润滑丧失以及男性勃起困难或没有伴侣，是老年女性性困难增加的常见原因。激素替代疗法不仅能改善局部解剖学和生理学变化，还可能带来积极的心理益处。（摘要截选至250词）
