背景:在育龄女性中,多囊卵巢综合征(PCOS)的患病率为10-15%。其特征是(i)临床或生化高雄激素血症,(ii)月经少经或闭经,和(iii)超声检查的多囊卵巢。PCOS与较低的生活质量有关,抑郁症,焦虑,糖尿病,和心血管疾病。治疗通常需要使用口服避孕药来降低内源性雄激素水平。雄激素水平和合并症可能会影响性功能。以前的研究已经解决了有限范围的可能的影响因素。与年龄匹配的健康对照组相比,我们将在实验室环境中评估PCOS女性的性功能以及生殖器和自我报告的性唤起。将研究所提到的生物心理社会因素的调节。
方法:这是一项多中心前瞻性病例对照研究。研究人群包括有和没有PCOS的健康女性,18-40岁,在至少6个月的稳定的异性恋关系中。在每组67名参与者处计算功率。预计下降10%,将招募150名参与者。
方法:使用女性性功能指数测量的主要结果是性功能,性欲清单,和女性性困扰量表修订;生殖器性唤起以阴道脉冲幅度测量;以及在实验室环境中对色情刺激的自我报告性唤起。将被调查的中介包括睾丸激素,游离雄激素水平,口服避孕药的使用,对雄激素的敏感性(使用CAG重复长度),身体质量指数,身体形象,心理健康,还有自尊.
结论:本研究的优点是纳入了广泛的生物心理社会结果指标,包括DNA分析,健康的对照组,以及在实验室环境中对生殖器和自我报告的性唤起进行标准化评估。通过这项研究的设计,我们旨在提供与PCOS相关的生物心理社会因素与性功能有关的见解。以及性功能如何受到治疗的影响。这些新见解可能有助于改善PCOS的临床管理,同时改善生活质量。牧师H,都是S,TimmanR,etal.多囊卵巢综合征女性的性功能:一项观察性前瞻性多中心病例对照研究的设计。性医学2020;8:718-729。
BACKGROUND: The prevalence of polycystic ovary syndrome (PCOS) is 10-15% in women of reproductive age. Its characteristics are (i) clinical or biochemical hyperandrogenism, (ii) oligomenorrhea or amenorrhea, and (iii) polycystic ovaries on ultrasound. PCOS is associated with lower quality of life, depression, anxiety, diabetes, and cardiovascular disease. Treatment commonly entails oral contraceptive use to lower endogenous androgen levels. Androgen levels and comorbidities may affect sexual function. Previous studies have addressed a limited range of possible contributing factors. We will assess sexual function as well as genital and self-reported sexual arousal in a laboratory setting in women with PCOS compared to an age-matched healthy control group. Modulation by biopsychosocial factors mentioned will be studied.
METHODS: This is a multicenter prospective
case control study. The study population includes healthy women with and without PCOS, aged 18-40 years, in a stable heterosexual relationship for at least 6 months. Power is calculated at 67 participants in each group. Anticipating a drop out of 10%, 150 participants will be recruited.
METHODS: The main outcomes measured are sexual function using the Female Sexual Function Index, Sexual Desire Inventory, and Female Sexual Distress Scale-Revised; genital sexual arousal measured as vaginal pulse amplitude; and self-reported sexual arousal in response to erotic stimuli in a laboratory setting. The mediators that will be investigated include testosterone, free androgen levels, oral contraceptive use, sensitivity to androgens (using CAG repeat length), body mass index, body image, mental health, and self-esteem.
CONCLUSIONS: Strengths of this study are the inclusion of a broad range of biopsychosocial outcome measures including DNA analysis, a healthy control group, and standardized assessment of genital and self-reported sexual arousal in a laboratory setting. With the design of this study we aim to provide an insight into which biopsychosocial factors associated with PCOS are related to sexual function, and how sexual function may be affected by treatment. These new insights may help to improve clinical management of PCOS while improving the quality of life. Pastoor H, Both S, Timman R, et al. Sexual Function in Women With Polycystic Ovary Syndrome: Design of an Observational Prospective Multicenter
Case Control Study. Sex Med 2020;8:718-729.