绝经过渡期和绝经后期女性睾酮水平对女性性功能的影响  

The impact of testosterone levels on female sexual function in menopausal transitional and postmenopausal women

作　　者：王志坤 阮祥燕[1,2] 刘莉莉 杨瑜 蒋玲玲 王泽铖 Alfred O.Mueck Wang Zhikun;Ruan Xiangyan;Liu Lili;Yang Yu;Jiang Lingling;Wang Zecheng;Alfred O.Mueck(Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing 100026,China;Department of Women's Health,Research Centre for Women's Health and University Women's Hospital of Tuebingen,University Hospitals of Tuebingen,Tuebingen D-72076,Germany)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院内分泌科,北京100026 [2]德国图宾根大学妇产医院妇女健康部与妇女健康研究中心,图宾根D-72076

出　　处：《首都医科大学学报》2024年第4期589-595,共7页Journal of Capital Medical University

基　　金：首批北京市级妇幼保健专科示范单位“更年期保健专科”项目[(2017)35号];北京市医院管理中心“登峰”人才培养计划项目(DFL20181401)。

摘　　要：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。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.

关 键 词：绝经过渡期 绝经 女性性功能障碍 睾酮 

分 类 号：R711[医药卫生—妇产科学]