背景:使用激素避孕药与不良反应有关,包括对性功能和性满意度的影响,尽管使用激素与非激素避孕方法对性功能的影响差异仍存在争议。
目的:在这项研究中,我们试图比较性交困难的患病率,性功能,性满意度,生活质量,焦虑,和使用荷尔蒙的女性之间的抑郁症,非荷尔蒙,或没有避孕方法,并将这些结果与最常用的避孕方法进行比较。
方法:这项横断面研究包括生育年龄的性活跃女性,她们分为3组:使用激素,非荷尔蒙,或者没有避孕方法。根据对研究参与者发放的问卷的使用情况,我们比较了3组的性功能,更具体地说是口服避孕药的使用者,铜和荷尔蒙宫内节育器,和屏障方法。
结果:参与者填写了4份评估性功能的问卷(女性性功能指数),性满意度(性商-女性版),生活质量(12项医疗结果短期健康调查),和焦虑和抑郁(医院焦虑和抑郁量表)。
结果:这项研究包括315名妇女,根据避孕药具的使用情况分为3组:激素避孕药组161名(中位[四分位范围]年龄,24[23-28]年),97在非激素避孕药组(年龄26[23-30]岁),无避孕方法组57人(年龄28[24-35]岁)。两组之间的性交困难患病率无差异。在生活质量领域,与非激素避孕组的女性相比,激素避孕组的女性更年轻,性功能满意度较低,减少唤醒,疼痛加剧(P<0.05),以及更高的焦虑和抑郁水平(P=0.03,两者),疼痛增加(P=0.01),总体健康状况较差(P=0.01)。在其他生活质量领域,这些组之间没有发现差异。关于避孕方法,使用铜宫内节育器的女性有更好的性功能,包括更高的觉醒率和更低的焦虑,使用口服避孕药的女性(P<0.05)。
结论:这项研究的结果强调了使用激素避孕方法的女性比非激素避孕方法的女性更差的性功能和性满意度以及更高的焦虑和抑郁水平。
■这项研究的发现加强了使用口服避孕药的女性与使用铜宫内节育器的女性之间性功能差异的证据。还比较了口服避孕药使用者的性功能,铜和荷尔蒙宫内节育器,和屏障方法。然而,不常用的避孕方法,比如荷尔蒙注射和阴道环,无法在此样本中进行比较。
结论:使用激素避孕方法的女性更年轻,性功能和满意度较低,与使用非激素避孕方法的女性相比,焦虑和抑郁水平更高。
Hormonal contraceptive use has been related to adverse effects, including impacts on sexual function and sexual satisfaction, although the difference in the effects on sexual function with the use of hormonal vs nonhormonal contraceptive methods remains controversial.
In this study we sought to compare the prevalence of dyspareunia, sexual function, sexual satisfaction, quality of life, anxiety, and depression between women using hormonal, nonhormonal, or no contraceptive methods and to compare these outcomes between the most frequently used contraceptive methods.
This cross-sectional study included sexually active women of reproductive age who were stratified into 3 groups: women using hormonal, nonhormonal, or no contraceptive methods. Based on the use of questionnaires administered to the study participants, we compared sexual function in the 3 groups and more specifically among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods.
Participants completed 4 questionnaires to assess sexual function (Female Sexual Function Index), sexual satisfaction (Sexual Quotient-Feminine Version), quality of life (12-item Medical Outcomes Short Form Health Survey), and anxiety and depression (Hospital Anxiety and Depression Scale).
This study included 315 women classified into 3 groups on the basis of contraceptive use: 161 in the hormonal contraceptives group (median [interquartile range] age, 24 [23-28] years), 97 in the nonhormonal contraceptives group (age 26 [23-30] years), and 57 in the no contraceptive methods group (age 28 [24-35] years). Dyspareunia prevalence showed no difference between the groups. In the quality of life domain, compared with women in the nonhormonal contraceptive group, women in the hormonal contraceptive group were younger and had lower sexual function satisfaction, reduced arousal, and heightened pain (P < .05), as well as higher anxiety and depression levels (P = .03, for both), increased pain (P = .01), and poorer overall health (P = .01). No difference was found between these groups in other quality of life domains. Regarding contraceptive methods, women using copper intrauterine devices had better sexual function, including higher rates of arousal and lower anxiety, than women using oral contraceptives (P < .05).
The results of this study highlight worse sexual function and sexual satisfaction and higher levels of anxiety and depression in women using hormonal contraceptive methods than in women using nonhormonal methods.
The findings of this study strengthen the evidence of differences in sexual function between women using oral contraceptives and those using copper intrauterine devices. Sexual function was also compared among users of oral contraceptives, copper and hormonal intrauterine devices, and barrier methods. However, less frequently used contraceptive methods, such as hormonal injections and vaginal rings, could not be compared in this sample.
Women using hormonal contraceptive methods were younger, had lower sexual function and satisfaction, and experienced higher anxiety and depression levels than women using nonhormonal contraceptive methods.