口服避孕药对多囊卵巢综合征患者性功能的影响

doi:10.3969/j.issn.1006-7795.2018.04.004

首都医科大学学报 ›› 2018, Vol. 39 ›› Issue (4): 499-504.doi: 10.3969/j.issn.1006-7795.2018.04.004

口服避孕药对多囊卵巢综合征患者性功能的影响

杜娟¹, 阮祥燕^1,2, Alfred O. Mueck^1,2

1. 首都医科大学附属北京妇产医院内分泌科, 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:2018-05-31 出版日期:2018-07-21 发布日期:2018-07-21
通讯作者: 阮祥燕 E-mail:ruanxiangyan@163.com
基金资助:
国家外专局引智重点项目（20181100005），北京市医院管理局"登峰"计划专项经费资助（DFL20181401），北京市卫生系统高层次卫生技术人才培养计划项目（2014-2-016），北京市医院管理局临床医学发展专项经费资助（XMLX201710），首都卫生发展科研专项（首发2016-2-2113），北京市科学技术委员会首都临床特色应用研究课题（Z161100000516143）。

Effects of oral contraceptives on sexual function in PCOS patients

Du Juan¹, Ruan Xiangyan^1,2, Alfred O. Mueck^1,2

1. Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
2. Department for Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tuebingen, Tuebingen D-72076, Germany

Received:2018-05-31 Online:2018-07-21 Published:2018-07-21
Supported by:
This study was supported by SAFEA:Project for Key Foreign Experts (20181100005), Beijing Municipal Administration of Hospitals' Ascent Plan (DFL20181401), Beijing Municipality Health Technology High-level Talent (2014-2-016), Beijing Municipal Administration of Hospitals Clinical medicine Development of Special Funding Support (XMLX201710), Capital's Funds for Health Improvement and Research (2016-2-2113), Beijing Municipal Science & Technology Commission (Z161100000516143).

摘要/Abstract

摘要： 目的评估口服避孕药（oral contraceptives，OCs）对多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者性功能的影响，并分析其女性性功能障碍（female sexual dysfunction，FSD）发生的危险因素。方法研究共纳入210例门诊PCOS患者，其中服用口服避孕药者126例（OC组），未服用者84例（NOC组）。采用网络女性性功能指数（Female Sexual Function Index，FSFI）量表，并补充附加问题，评估参与者的基本信息、避孕方法、性伴侣关系稳定程度、孕产史等多个女性性功能的潜在影响因素。结果 OC组FSFI总分中位数为26.35分，50.79%表现为FSD高风险；NOC组FSFI总分中位数26.85分，47.62%显示FSD高风险；两组得分相比差异无统计学意义（P=0.635）。在口服避孕药使用者中，服用35 μg炔雌醇/2 mg醋酸环丙孕酮、30 μg炔雌醇/3 mg屈螺酮、30 μg炔雌醇/150 μg去氧孕烯三种不同成分口服避孕药的患者之间，FSFI得分差异无统计学意义。经Logistic回归分析，性生活是否主动、伴侣关系是否稳定是PCOS患者性功能的影响因素。结论 PCOS患者中，是否服用口服避孕药、服用不同类型口服避孕药的患者之间性功能评分差异均无统计学意义。PCOS患者性功能的潜在影响因素中，性生活是否主动、伴侣关系是否稳定与FSD高风险的发生相关。

关键词: 女性性功能障碍, 网络女性性功能指数量表(FSFI), 影响因素, 多囊卵巢综合征, 口服避孕药

Abstract: Objective To investigate the effects of oral contraceptives on sexual function in polycystic ovary syndrome (PCOS) patients. Methods The online questionnaire was completed by PCOS patients in clinic. PCOS patients in the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University were enrolled. They were divided into two groups taking oral contraceptives (OC group) not taking OC (NOC group). The primary endpoint was the Female Sexual Function Index (FSFI) score, with additional questions on contraception, sexual activity, relationship stability, pregnancy and other factors which may influence sexual function. Results Totally 210 PCOS patients were recruited in this study to participate in the survey using the online questionnaire. Of all women participating, 126 were taking oral contraceptives (OC group) and 84 were not taking OC (NOC group). Among OC users, the median FSFI total score was 26.35, and 50.79% showed high risk of female sexual dysfunction (FSD). Regarding NOC group, the median FSFI total score was 26.85, 47.62% showed high risk of FSD. There was no significant difference between two groups (P=0.635). Also, no differences of FSFI scores were seen in patients taking 35 μg ethinyl estradiol (EE)/2 mg cyproterone acetate (CPA), 30 μg EE/3 mg drospirenone(DRSP), and 30 μg EE/150 μg desogestrel. Relationship stability and sexual activity were found to be associated with sexual function in PCOS patients. Conclusion There was no significant difference between OC users and not taking OC users in PCOS patients. Different progestins in OCs and the EE dosage in OCs have no significant influence on sexual function in PCOS patients. Regarding PCOS patients, sexual activity and relationship stability may be risk factors of FSD.

Key words: female sexual dysfunction, Female Sexual Function Index (FSFI), risk factors, polycystic ovary syndrome (PCOS), oral contraceptive

中图分类号:

R711.75

杜娟, 阮祥燕, Alfred O. Mueck. 口服避孕药对多囊卵巢综合征患者性功能的影响[J]. 首都医科大学学报, 2018, 39(4): 499-504.

Du Juan, Ruan Xiangyan, Alfred O. Mueck. Effects of oral contraceptives on sexual function in PCOS patients[J]. Journal of Capital Medical University, 2018, 39(4): 499-504.

参考文献

[1] Hatzimouratidis K, Hatzichristou D. Sexual dysfunction:classifications and definitions[J]. J Sex Med, 2007, 4(1):241-250.
[2] Graziottin A, Serafini A, Palacios S. Aetiology, diagnostic algorithms and prognosis of female sexual dysfunction[J]. Maturitas, 2009, 63(2):128-134.
[3] Li R, Zhang Q, Yang D, et al. Prevalence of polycystic ovary syndrome in women in China:a large community-based study[J]. Hum Reprod, 2013, 28(9):2562-2569.
[4] Davis S R, Davison S L, Donath S. Circulating androgen levels and self-reported sexual function in women[J]. JAMA, 2005, 294(1):91-96.
[5] Rotterdam ESHRE/ASRM-sponsored. PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long term health risks related to polycystic ovary syndrome[J]. Hum Repro, 2004, 19(1):41-47.
[6] Sun X, Li C, Jin L, et al. Development and validation of Chinese version of female sexual function index in a Chinese population-a pilot study[J]. J Sex Med, 2011, 8(4):1101-1111.
[7] Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI):cross-validation and development of clinical cutoff scores[J]. J Sex Marital Ther, 2005, 31(1):1-20.
[8] Pastor Z, Holla K, Chmel R. The influence of combined oral contraceptives on female sexual desire:A systematic review[J]. Eur J Contracept Reprod Health Care, 2013, 18(1):27-43.
[9] Mark K P, Leistner C E, Garcia J R. Impact of contraceptive type on sexual desire of women and of men partnered to contraceptive users[J]. J Sex Med, 2016, 13(9):1359-1368.
[10] Davis S R, Bitzer J, Giraldi A, et al. Change to either a nonandrogenic or androgenic progestin-containing oral contraceptive preparation is associated with improved sexual function in women with oral contraceptive-associated sexual dysfunction[J]. J Sex Med, 2013, 10(12):3069-3079.
[11] Smith N K, Jozkowski K N, Sanders S A. Hormonal contraception and female pain, orgasm and sexual pleasure[J]. J Sex Med, 2014, 11(2):462-470.
[12] Du J, Ruan X, Gu M, et al.Prevalence of and risk factors for sexual dysfunction in young Chinese women according to the Female Sexual Function Index:an internet-based survey[J]. Eur J Contracept Reprod Health Care, 2016, 21(3):259-263.
[13] Lara L A, Ramos F K, Kogure G S, et al. Impact of physical resistance training on the sexual function of women with polycystic ovary syndrome[J]. J Sex Med, 2015, 12(7):1584-1590.
[14] Zueff L N, Lara L A, Vieira C S, et al. Body composition characteristics predict sexual functioning in obese women with or without PCOS[J]. J Sex Marital Ther, 2015, 41(3):227-237.
[15] Kowalczyk R, Skrzypulec-Plinta V, Nowosielski K, et al. Sexuality in women with polycystic ovary syndrome[J]. Ginekol Pol, 2015, 86(2):100-106.
[16] Ferraresi S R, Lara L A, Reis R M, et al. Changes in sexual function among women with polycystic ovary syndrome:A pilot study[J]. J Sex Med, 2013, 10(2):467-473.
[17] Benetti-Pinto C L, Ferreira S R, Antunes A Jr, et al. The influence of body weight on sexual function and quality of life in women with polycystic ovary syndrome[J]. Arch Gynecol Obstet, 2015, 291(2):451-455.
[18] Wallwiener C W, Wallwiener L M, Seeger H, et al.Are hormonal components of oral contraceptives associated with impaired female sexual function? A questionnaire-based online survey of medical students in Germany, Austria, and Switzerland[J]. Arch Gynecol Obstet, 2015, 292(4):883-890.

口服避孕药对多囊卵巢综合征患者性功能的影响

Effects of oral contraceptives on sexual function in PCOS patients

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