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目的 调查围绝经期女性性健康现状，分析性功能障碍的影响因素，探讨夫妻调适关系在围绝经期症状与性功能障碍间的作用机制。方法 以2025年4—12月于北京协和医院妇科门诊就诊的274例围绝经期女性为研究对象，采用便利抽样法，通过一般资料调查表、女性性功能指数、围绝经期评定量表(MRS)、改良版二元调适量表(R-DAS14)等工具进行调查，运用中介效应分析探讨变量关系。结果 围绝经期女性性功能指数总得分为[41.34(10.50,63.00)]分，性功能障碍者占调查对象总人数的32.8%(90/274);各维度得分中，得分最低的维度为性欲维度[2.00(1.00,3.00)]分、性唤起维度[2.01(1.00,3.00)]分。影响因素分析显示，结婚年限长[OR=0.303,95%CI(0.151,0.609)]、围绝经期症状严重[OR=0.950,95%CI(0.906,0.997)]是性功能障碍的风险因素(P<0.05),而夫妻调适关系和谐[OR=1.037,95%CI(1.016,1.058)]是保护因素(P<0.05);夫妻调适关系在围绝经期症状与性功能障碍间起部分中介作用(间接效应占比18.89%)。结论 围绝经期女性性健康问题需重视，临床应关注婚姻持续时间、围绝经期症状及夫妻关系，通过多维度干预降低性功能障碍风险。
Abstract：Objectives:To investigate the sexual health status of perimenopausal women and analyze the influencing factors of sexual dysfunction, then to explore the mechanism of marital adjustment in the relationship between perimenopausal symptoms and sexual dysfunction.Methods:A total of 274 perimenopausal women who visited the gynecology clinic of Peking Union Medical College Hospital from April to December 2025 were selected as subjects by convenient sampling. Data were collected through general information questionnaire, Female Sexual Function Index, Menopause Rating Scale(MRS),Revised Dyadic Adjustment Scale-14(R-DAS14) and other tools, and mediating effect analysis was used to explore the relationship between variables.Results:The results showed that the total score of Female Sexual Function Index in perimenopausal women was [41.34(10.50,63.00)],and 32.8%(90/274) of them had sexual dysfunction. Among the scores of each dimension, the lowest scores were in sexual desire [2.00(1.00,3.00)] and sexual arousal [2.01(1.00,3.00)]. Analysis of influencing factors showed that longer marriage duration [OR=0.303,95%CI(0.151,0.609)] and severe perimenopausal symptoms [OR=0.950,95%CI(0.906,0.997)] were risk factors for sexual dysfunction(P<0.05),while harmonious marital adjustment [OR=1.037,95%CI(1.016,1.058)] was a protective factor(P<0.05). Marital adjustment played a partial mediating role between perimenopausal symptoms and sexual dysfunction(indirect effect accounted for 18.89%).Conclusions:Sexual health problems of perimenopausal women should be paid attention to. Clinically, attention should be paid to marriage duration, perimenopausal symptoms and marital relationship. The multi-dimensional intervention should be taken to reduce the risk of sexual dysfunction.
[1]世界卫生组织．更年期[EB/OL].[2025-7-29].https：//www.who.int/zh/news-room/fact-sheets/detail/menopause．
[2]Cucinella L,Tiranini L,Nappi RE.Sexual health and contraception in the menopause journey[J].Best Pract Res Clin Endocrinol Metab,2024,38:101822．
[3]Simić Stanojević I,Piatt J,Herbenick D,et al.She said，“Really,you’re just going to have to suffer through it”:The lack of discussion of perimenopause between women and healthcare professionals[J].J Sex Marital Ther,2024,50:1030-1045．
[4]向凤，曹学华，胡婉琴，等．围绝经期和绝经后女性性功能障碍发病率的Meta分析[J]．中国全科医学，2024,27:3312-3313．
[5]鞠蕊，阮祥燕，许新，等．围绝经期及绝经后女性性功能障碍状况及与更年期症状的关系分析[J]．首都医科大学学报，2020,41:503-507．
[6]Gatenby C,Simpson P.Menopause:physiology,definitions,and symptoms[J].Best Pract Res Clin Endocrinol Metab,2024,38:101855．
[7]楼青青，张琴薇，姚慧岚，等．女性性功能量表的汉化及其信效度评价[J]．中国实用护理杂志，2013,29:23-26．
[8]黄琳，刘琴，刘月．围绝经期评定量表Menopause Rating Scale(MRS）中文版信度及效度分析[J]．护理研究，2018,32:3435-3437．
[9]吕繁，曾光，刘松暖，等．家庭关怀度指数问卷测量脑血管病病人家庭功能的信度和效度研究[J]．中国公共卫生，1999,15:27-28．
[10]Li M,Chan CWH,Choi KC,et al.The Chinese version of the Revised Dyadic Adjustment Scale for gynaecological cancer patients and their partners:Translation and psychometric evaluation[J].Asia Pac J Oncol Nurs,2022,9:48-54．
[11]孙振晓，刘化学，焦林瑛，等．医院焦虑抑郁量表的信度及效度研究[J]．中华临床医师杂志（电子版），2017,11:198-201．
[12]费何，张丽文，顾勉琴，等．上海市某区中老年女性性功能的影响因素分析[J]．中国初级卫生保健，2019,33:44-45．
[13]Lara LA,Cartagena-Ramos D,Figueiredo JB,et al.Hormone therapy for sexual function in perimenopausal and postmenopausal women[J].Cochrane Database Syst Rev,2023,8:CD009672．
[14]宋梦玲，魏松英，高慧敏，等．个体化绝经激素治疗对围绝经期妇女骨密度改善的疗效分析[J]．生殖医学杂志，2024,33:1153-1158．
[15]Zhuo Z,Wang C,Yu H,et al.The relationship between pelvic floor function and sexual function in perimenopausal women[J].Sex Med,2021,9:100441．
[16]Yoldemir T.Perimenopausal combined hormonal contraception:focus on sexual function[J].Climacteric,2025,28:15-20．
[17]王婕，邓姗．针对特定围绝经期女性单用雌激素缓解更年期症状的治疗体会[J]．生殖医学杂志，2025,34:662-666．
[18]Iliescu DG,Petrita R,Teodorescu C,et al.Real-world performance and safety of vaginal ovules in reducing the vaginal symptoms associated with vulvovaginal atrophy and postmenopausal sexual dysfunction[J].Biomed Rep,2024,20:35．
[19]Szpak R,Folwarczny W,Drozdzol A,et al.Partner relationships in menopausal period[J].Ginekol Pol,2010,81:115-119．
[20]Karimi L,Mokhtari Seghaleh M,Khalili R,et al.The effect of self-care education program on the severity of menopause symptoms and marital satisfaction in postmenopausal women:a randomized controlled clinical trial[J].BMC Womens Health,2022,22:71．
[21]Rullo JE,Sood R,Fokken SC,et al.Couples’use of online stress management and resiliency training for sexual health concerns:a randomized controlled trial[J].Sex Med,2021,9:100404．
[22]Yarelahi M,Karimi M,Asadollahi A.Dose spouses’coping skills promote qol and dyadic coping of menopausal women?[J].Women Health,2021,61:431-439．
[23]Kim EJ,Nho JH.Trajectories of subjective health status among married postmenopausal women based on the ecological system theory:a longitudinal analysis using a latent growth model[J].Korean J Women Health Nurs,2022,28:123-133.
基本信息:
中图分类号:R711.75
引用信息:
[1]田策,刘迎,王雪新,等.围绝经期女性夫妻调适关系在围绝经期症状与性功能障碍之间的中介作用[J].生殖医学杂志,2026,35(03):341-348.
基金信息:
北京协和医院护理科研资金资助（XHHLKY202511）
2025-08-26
2025
2025-11-20
2026-02-06
2026
1
2026-03-15
2026-03-15