围绝经期与绝经后女性雄激素浓度对情绪障碍及性功能障碍的影响

doi:10.3969/j.issn.1006-7795.2023.04.002

首都医科大学学报 ›› 2023, Vol. 44 ›› Issue (4): 517-523.doi: 10.3969/j.issn.1006-7795.2023.04.002

• 妇科内分泌绝经与生育力保护 • 上一篇下一篇

围绝经期与绝经后女性雄激素浓度对情绪障碍及性功能障碍的影响

王志坤¹, 阮祥燕^1*, 鞠蕊¹, 杨瑜¹, 蒋玲玲¹, 程姣姣¹, 李妍秋¹, 谷牧青¹, 刘莉莉¹, 王泽铖¹, Alfred O.Mueck^1，2

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，德国

收稿日期:2023-05-09 出版日期:2023-08-21 发布日期:2023-07-23
通讯作者: 阮祥燕 E-mail:ruanxiangyan@ccmu.edu.cn
基金资助:
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)

The effect of androgen levels on mood disorders and sexual dysfunction in peri-and postmenopausal Chinese women

Wang Zhikun¹, Ruan Xiangyan^1*, Ju Rui¹, Yang Yu¹, Jiang Lingling¹, Cheng Jiaojiao¹, Li Yanqiu¹, Gu Muqing¹, Liu Lili¹, Wang Zecheng¹, Alfred O.Mueck^1，2

1.Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Beijing Maternal and Child Health Care Hospital, Beijing 100026, China; 2.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

Received:2023-05-09 Online:2023-08-21 Published:2023-07-23
Supported by:
This study was supported by the First Batch of Beijing Maternal and Child Health Specialist Demonstration Units“Menopausal Health Specialist”［(2017) 35］， Beijing Municipal Administration of Hospitals' Ascent Plan (DFL20181401).

摘要/Abstract

摘要： 目的探讨围绝经期与绝经后女性雄激素浓度对情绪障碍及性功能障碍的影响。方法募集2022年1月至2022年12月于首都医科大学附属北京妇产医院内分泌科就诊的280例40~65岁女性，包括绝经前76例、围绝经期84例和绝经后120例，测量身高、体质量、血压、腰围、臀围等指标，进行包括情绪障碍和性功能障碍等绝经相关症状的问卷调查。将围绝经期及绝经后女性分为情绪障碍组及对照组，性功能障碍组及对照组，采用化学发光免疫法检测血清卵泡刺激素、黄体生成素、雌二醇、孕酮、催乳素浓度，采用液相色谱串联质谱法检测血清性激素结合球蛋白、总睾酮、游离睾酮、生物活性睾酮、脱氢表雄酮、硫酸脱氢表雄酮、雄烯二酮、双氢睾酮浓度。结果与绝经前相比，围绝经期与绝经后女性的血清游离睾酮、生物活性睾酮、雄烯二酮、脱氢表雄酮、硫酸脱氢表雄酮浓度显著降低（P <0.05），但这些激素浓度在围绝经期与绝经后女性中差异无统计学意义（P > 0.05）；与绝经前相比，围绝经期与绝经后女性血清总睾酮浓度稍降低，但差异无统计学意义（（P ＞ 0.05）；围绝经期与绝经后女性情绪障碍与血清总睾酮浓度降低有关（P <0.05），性功能障碍与血清硫酸脱氢表雄酮浓度降低有关（P <0.05）。结论围绝经期与绝经后女性多种雄激素浓度下降，情绪障碍与血清总睾酮浓度降低有关，性功能障碍与血清硫酸脱氢表雄酮浓度降低有关。

关键词: 围绝经期, 绝经, 情绪障碍, 女性性功能障碍, 雄激素

Abstract: Objective To study the effect of peri-and postmenopausal androgen levels on mood disorders and female sexual dysfunction (FSD). Methods From Jan. 2022 to Dec. 2022, a total of 280 women aged 40-65 years who attended the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University were recruited and divided into 76 premenopausal, 84 perimenopausal and 120 postmenopausal women. Height, weight, blood pressure, waist circumference, and hip circumference were measured. Questionnaires on menopause-related symptoms including mood disorders and sexual dysfunction were administered. The peri-and postmenopausal women were divided into emotional disorders group and control group, sexual dysfunction group and control group. The levels of serum follicle stimulating hormone(FSH), luteinizing hormone(LH), and estradiol(E2) were measured with chemiluminescence immunoassay, and the levels of serum sex hormone binding globulin(SHBG), total testosterone(TT), free testosterone(FT), bioactive testosterone(BT), dehydroepiandrosterone(DHEA), dehydroepiandrosterone sulfate(DHEA-S), androstenedione(A2), and dihydrotestosterone(DHT) were tested with liquid chromatography-tandem mass spectrometry(LC-MS/MS).Results Compared with premenopausal women, the serum levels of FT, BT, A2, DHEA, and DHEA-S were significantly lower in peri- and postmenopausal women (P < 0.05), but not significantly different between peri- and postmenopausal women (P > 0.05). The serum TT levels were slightly lower in peri- and postmenopausal women, but the difference was not significant (P > 0.05). The serum TT levels were negatively correlated with mood disorders (P<0.05) and serum DHEA-S levels were negatively correlated with sexual dysfunction (P<0.05).Conclusions Multiple androgen levels declined in peri- and postmenopausal women, mood disorders were negatively correlated with serum TT levels, and FSD was negatively correlated with serum DHEA-S levels.

Key words: perimenopause, menopause, mood disorders, female sexual dysfunction, androgens

中图分类号:

R711.75

王志坤, 阮祥燕, 鞠蕊, 杨瑜, 蒋玲玲, 程姣姣, 李妍秋, 谷牧青, 刘莉莉, 王泽铖, Alfred O.Mueck. 围绝经期与绝经后女性雄激素浓度对情绪障碍及性功能障碍的影响[J]. 首都医科大学学报, 2023, 44(4): 517-523.

Wang Zhikun, Ruan Xiangyan, Ju Rui, Yang Yu, Jiang Lingling, Cheng Jiaojiao, Li Yanqiu, Gu Muqing, Liu Lili, Wang Zecheng, Alfred O.Mueck. The effect of androgen levels on mood disorders and sexual dysfunction in peri-and postmenopausal Chinese women[J]. Journal of Capital Medical University, 2023, 44(4): 517-523.

参考文献

［1］于奇, 杜纯静, 杜恩情, 等. 基于年鉴资料比较的我国预期寿命变动及预测分析［J］. 中国卫生统计, 2019, 36(6): 814-817.
［2］ Ruan X Y, Cui Y M, Du J, et al. Prevalence of climacteric symptoms comparing perimenopausal and postmenopausal Chinese women［J］. J Psychosom Obstet Gynaecol, 2017, 38(3): 161-169.
［3］ Zhang L Y, Ruan X Y, Cui Y M, et al. Menopausal symptoms among Chinese peri-and postmenopausal women: a large prospective single-center cohort study［J］. Gynecol Endocrinol, 2021, 37(2): 185-189.
［4］ Bachmann G A. The hypoandrogenic woman: pathophysiologic overview［J］. Fertil Steril, 2002, 77 Suppl 4: S72-S76.
［5］ Fonseca H P, Scapinelli A, Aoki T, et al. Androgen deficiency in women［J］. Rev Assoc Med Bras (1992), 2010, 56(5): 579-582.
［6］ Mernone L, Fiacco S, Ehlert U. Psychobiological factors of sexual functioning in aging women-findings from the women 40+ healthy aging study［J］. Front Psychol, 2019, 10: 546.
［7］ Santoro N, Torrens J, Crawford S, et al. Correlates of circulating androgens in mid-life women: the study of womens health across the nation［J］. J Clin Endocrinol Metab, 2005, 90(8): 4836-4845.
［8］ Nappi R E, Albani F, Santamaria V, et al. Hormonal and psycho-relational aspects of sexual function during menopausal transition and at early menopause［J］. Maturitas, 2010, 67(1): 78-83.
［9］ Harlow S D, Gass M, Hall J E, et al. Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging［J］. Climacteric, 2012, 15(2): 105-114.
［10］ Nappi R E, Di Carlo C, Cucinella L, et al. Viewing symptoms associated with Vulvovaginal Atrophy (VVA)/Genitourinary syndrome of menopause (GSM) through the estro-androgenic lens-cluster analysis of a web-based Italian survey among women over 40［J］. Maturitas, 2020, 140: 72-79.
［11］多囊卵巢综合征雄激素质谱检测共识专家组, 中国人体健康科技促进会生育力保护与保存专业委员会. 多囊卵巢综合征雄激素质谱检测专家共识［J］. 检验医学, 2023, 38(3): 203-208.
［12］ Davison S L, Bell R, Donath S, et al. Androgen levels in adult females: changes with age, menopause, and oophorectomy［J］. J Clin Endocrinol Metab, 2005, 90(7): 3847-3853.
［13］ Elmlinger M W, Kühnel W, Wormstall H, et al. Reference intervals for testosterone, androstenedione and SHBG levels in healthy females and males from birth until old age［J］. Clin Lab, 2005, 51(11/12): 625-632.
［14］ Al-Azzawi F, Palacios S. Hormonal changes during menopause［J］. Maturitas, 2009, 63(2): 135-137.
［15］ Morsink L F J, Vogelzangs N, Nicklas B J, et al. Associations between sex steroid hormone levels and depressive symptoms in elderly men and women: results from the Health ABC study［J］. Psychoneuroendocrinology, 2007, 32(8/10): 874-883.
［16］ Gracia C R, Sammel M D, Freeman E W, et al. Predictors of decreased libido in women during the late reproductive years［J］. Menopause, 2018, 25(11): 1238-1243.
［17］ Smith R L, Gallicchio L, Flaws J A. Factors affecting sexual activity in midlife women: results from the midlife health study［J］. J Womens Health (Larchmt), 2017, 26(2): 103-108.

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围绝经期与绝经后女性雄激素浓度对情绪障碍及性功能障碍的影响

The effect of androgen levels on mood disorders and sexual dysfunction in peri-and postmenopausal Chinese women

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