Influence of Sexual Function on the Social Relations and Quality of Life of Women with Premature Ovarian Insufficiency

Abstract Objective To evaluate the impact of sexual function (SF) in the quality of life (QoL) of women with premature ovarian insufficiency (POI). Methods Case-control study in which 80women with POIwere evaluated using estrogen plus progestogen therapy, compared with 80 women matched by age (2 years) and presenting preserved gonadal function. Sexual function was evaluated using the Female Sexual Function Index (FSFI), and the QoL was evaluated using theWorld Health Organization's (WHO) QoL assessment instrument (WHOQoL-BREF). Results The mean age of the women with POI and of the control group was 38.4 ± 7.3 years and 38.1 ± 7.3 years respectively. The QoL, was worse among the POI group, and there were significant differences in the physical (63.4 ± 17.4 and 72.7 ± 15.2 respectively, p = 0.0004) and psychological (63.2 ± 14.6 and 69.3 ± 13.9 respectively, p = 0.0075) domains among this group when compared with the control group. Women with POI presented significantly lower arousal, lubrication, orgasm and satisfaction, more dyspareunia and a worse FSFI scores when compared with the control group. All aspects of SF correlate directly with the worsening of the QoL regarding social relationships. Conclusion Women with POI showed worse QoL and SF than the control group. The psychological aspects (desire, excitement, orgasm and sexual satisfaction) of SF had greater influence on the parameters of the QoL, while the physical aspects (pain and lubrication) had a low impact on the QoL. The poor SF in women with POI is directly correlated with a worsening acrossmultiple domains of the QoL; however, the negative impact is particularly important in the social domain. These results suggest that the improvement in sexuality can improve the social interactions of women with POI.摘要 目的 评估早发性卵巢功能不全（premature ovarian insufficiency, POI）女性的性功能（sexual function, SF）对其生活质量（quality of life, QoL）的影响。方法 采用病例对照研究设计，纳入80例接受雌孕激素联合治疗的POI女性，以年龄匹配（±2岁）且性腺功能保留的80名女性作为对照。采用女性性功能指数（Female Sexual Function Index, FSFI）评估受试者的性功能，采用世界卫生组织生活质量评定量表简表（World Health Organization Quality of Life Assessment Instrument-BREF, WHOQoL-BREF）评估其生活质量。结果 POI组与对照组受试者的平均年龄分别为38.4±7.3岁与38.1±7.3岁。POI组的生活质量更差，与对照组相比，其生理领域（分别为63.4±17.4与72.7±15.2，p=0.0004）与心理领域（分别为63.2±14.6与69.3±13.9，p=0.0075）的差异均具有统计学意义。与对照组相比，POI女性的性唤起、润滑、性高潮及性满意度均显著更低，性交痛发生率更高，且女性性功能指数总分更差。性功能各维度均与社会关系领域的生活质量恶化呈直接正相关。结论 POI女性的生活质量与性功能均劣于对照组。性功能的心理维度（性欲、性唤起、性高潮与性满意度）对生活质量各参数的影响更大，而生理维度（性交痛与润滑状况）对生活质量的影响较弱。POI女性的性功能低下与生活质量多个领域的恶化直接相关，其中对社会领域的负面影响尤为显著。上述结果提示，改善性功能可提升POI女性的社会互动能力。