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女性性功能障碍

最后审阅: 5 Oct 2024
最后更新: 06 Dec 2022

小结

定义

病史和体格检查

关键诊断因素

  • 导致苦恼的性症状
  • 对性活动的兴趣缺失/减少(SIAD)
  • 性/色情想法或幻想缺失/减少(SIAD)
  • 性活动期间的性兴奋/性快感缺失/减少(SIAD)
  • 对色情或性刺激没有主观性唤起(SIAD)
  • 性活动期间的生殖器或非生殖器感觉缺失/减少(SIAD)
  • 性活动发起行为缺失/减少(SIAD)
  • 性高潮缺失或强度极小(FOD)
  • 性高潮明显延迟(FOD)
  • 性高潮频率明显不足(FOD)
  • 自发、令人苦恼、不愉悦的生殖器充血以及感觉到即将发生性高潮(PGAD/GPD)
完整详情

其他诊断因素

  • 目前的应激源
  • 性活动期间消极情感
  • 外阴阴道萎缩
  • 溢乳
完整详情

危险因素

  • 抑郁症
  • 使用抗抑郁药
  • 共患的焦虑障碍
  • 癌症的心理方面
  • 乳腺癌
  • 妇科和其他盆腔癌症
  • 神经系统疾病
  • 子宫内膜异位症
  • 高催乳素血症
  • 根治性子宫切除术(未保留神经)
  • 膀胱切除术或直肠切除术
  • 性格因素和态度
  • 人际关系困难
  • 伴侣性功能障碍
  • 雄激素活性降低
  • 雌激素缺乏
  • 卵巢功能早衰
  • 产后
  • 年龄增加
  • 糖尿病
  • 肾功能不全
  • 心血管疾病
  • 多囊卵巢综合征 (PCOS)
  • 药物或物质使用
  • 下丘脑-垂体疾病
  • 不育症
  • 下尿路症状 (LUTS)
  • 社会经济地位
  • 性虐待和发育创伤
完整详情

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • 血清葡萄糖水平
  • 肾功能
  • 甲状腺功能检测
  • 血清催乳素水平
完整详情

治疗流程

持续性治疗

性欲/性唤起障碍

女性性高潮障碍(FOD)

物质/药物诱发的性功能障碍

撰稿人

作者

Miriam Driscoll, MD, FRCP(C)

Clinical Assistant Professor

Department of Psychiatry

Associate Member Department of Obstetrics and Gynaecology

University of British Columbia

Physician

BC Center for Sexual Medicine

Vancouver Coastal Health Authority

Vancouver

Canada

利益声明

MD declares that she has no competing interests.

Leah Rosetti, MD, FRCP(C)

Fellow

Department of Psychiatry

University of British Columbia

Physician

BC Centre for Sexual Medicine

Vancouver Coastal Health Authority

Vancouver

Canada

利益声明

LR declares that she has no competing interests.

鸣谢

Dr Miriam Driscoll and Dr Leah Rosetti would like to gratefully acknowledge Dr Lori Brotto and Dr Rosemary Basson, previous contributors to this topic.

利益声明

LB is an author or co-author of several references cited in this topic. RB is an author or co-author of several references cited in this topic. RB's department has received research funding from the Canadian Institutes of Health Research (CIHR).

同行评议者

Holly N. Thomas, MD, MS

Assistant Professor of Medicine

University of Pittsburgh

Pittsburgh

PA

利益声明

HNT received a research award from the North American Menopause Society that was funded by AMAG Pharmaceuticals, who originally developed bremelanotide alongside Palatain Technologies.

Philip Kell, MBBS, FRCOG, FRCP

Consultant Physician

Archway Sexual Health Clinic

Whittington Hospital

London

UK

利益声明

PK has undertaken research studies for Boehringer Ingelheim.

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