目的 探索绝经过渡期和绝经后期女性雄激素水平对性功能的影响.方法 募集 2023 年 1 月至 2023 年 12 月首次来首都医科大学附属北京妇产医院就诊的绝经过渡期和绝经后期女性,纳入符合纳入标准和排除标准的女性 450 例,收集人口统计学资料和既往病史、应用女性性功能指数(female sexual function index,FSFI)量表、改良Kupperman评分量表评价女性性功能和围绝经期症状;测量人体测量学指标;检测实验室指标包括总睾酮、游离睾酮、生物活性睾酮、4-雄烯二酮和雌激素.采用相关和回归分析探索雄激素水平对女性性功能的影响.结果 与绝经过渡期相比,绝经后期女性FSFI量表的各维度得分和总分明显下降(P<0.05).多元线性回归分析显示生物活性睾酮水平与性唤起得分(β=0.190,P<0.05)和FSFI总分(β=0.178,P<0.05)呈正相关,游离睾酮水平与性欲(β=0.166,P<0.05)、性满意度(β=0.176,P<0.05)、FSFI总分(β=0.126,P<0.05)呈正相关.改良Kupperman评分与FSFI总分及各维度得分呈负相关(P<0.05).结论 女性性功能障碍与游离睾酮和生物活性睾酮水平下降有关,与总睾酮水平无关.
The impact of testosterone levels on female sexual function in menopausal transitional and postmenopausal women
Objective To explore the impact of testosterone levels on female sexual function in menopausal transitional and postmenopausal women.Methods A total of 450 menopausal transitional and postmenopausal women who visited Beijing Obstetrics and Gynecology Hospital for the first time from January to December 2023 were recruited,including 201 menopausal transitional and 249 postmenopausal women.Demographic data and medical history were collected,female sexual function and climacteric symptoms were evaluated by using female sexual function index(FSFI)scale and modified Kupperman index(KMI).The sex hormone levels were tested for all women,including total testosterone(TT),free testosterone(FT),bioactive testosterone(BioT),4-androstenedione(A4)and estrogen.Multiple linear regression is used to explore the impact of testosterone levels on female sexual function.Results Compared with menopausal transitional women,the FSFI scores in postmenopausal women decreased significantly(P<0.05).Multiple linear regression analysis showed that BioT level was positively correlated with arousal score(β=0.190,P<0.05)and FSFI total score(β=0.178,P<0.05),FT level was positively correlated with desire(β=0.166,P<0.05),satisfaction(β=0.176,P<0.05),and FSFI total score(β=0.126,P<0.05),while TT level was not associated with FSFI scores.The KMI score is negatively correlated with the FSFI scores(P<0.05).Conclusions Female sexual dysfunction(FSD)was associated with reduced FT and BioT levels,while not associated with TT level.
perimenopausemenopausefemale sexual dysfunctiontestosterone
NETL
NSTL
万方数据
