Prevalence and influencing factors of female sexual dysfunction in Chinese women: a cross-sectional analysis
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摘要:
目的 调查分析中国女性性功能障碍(FSD)流行病学现状及相关影响因素。 方法 于2019年2 — 5月,利用问卷星网络平台,使用女性性功能指数问卷(FSFI)及编制的相关因素问卷,对中国23个省、4个直辖市、2个特别行政区和5个自治区14 306名18~69岁有性生活史的女性进行随机横断面调查,采用logistic回归分析、方差分析及卡方检验等方法进行FSD影响因素分析。 结果 调查人群中FSD总发生率为53.17 %(7 606/14 306),其中性欲望障碍和性满意度障碍发生率较高,分别为46.17 %(6 605/14 306)、46.97 %(6 720/14 306)。logistic回归分析结果表明,FSD的发生与年龄(OR = 1.875,95 % CI = 1.553~2.265)、文化程度(OR = 0.737,95 % CI = 0.587~0.924)、职业(OR = 1.189,95 % CI = 1.030~1.373)、收入(OR = 1.247,95 % CI = 1.081~1.438)、妇科疾病(OR = 1.301,95 % CI = 1.136~1.490)、是否绝经(OR = 2.354,95 % CI = 1.712~3.238)等因素相关,而与是否生育、分娩情况及次数等因素无关。 结论 中国FSD发病率较高,影响女性的生活质量及心理健康,根据病因对症干预和治疗,促进女性群体性与生殖健康意义重大。 Abstract:Objective To investigate prevalence and influencing factors of female sexual dysfunction (FSD) among Chinese women. Methods During February – May 2019, a random online survey was conducted among 14 306 women aged 18 – 69 from 23 provinces, 4 municipalities directly under the central government, 2 special administrative regions and 5 autonomous regions in China by using the FSFI and the related factors questionnaire. Logistic regression analysis, analysis of variance and chi square test were adopted in data analyses. Results Of the 14 306 participants with valid information, 53.17% (7 606) reported FSD symptoms; 46.17% (6 605) and 46.97% (6 720) reported having sexual desire and satisfaction disorder, respectively. The results of logistic regression analysis revealed following significant influencing factors of FSD: age (≥ 30 vs. 18 – 29: odds ratio (OR) = 1.875, 95% confidence interval (95% CI: 1.553 – 2.265), education level (senior high school and above vs. junior high school and below: OR = 0.737, 95% CI: 0.587 – 0.924), occupation (non-manual worker vs. manual worker: OR = 1.189, 95% CI: 1.030 – 1.373), monthly household income per capita (≥ 3 000 vs. < 3 000 RMB yuan: OR = 1.247, 95% CI: 1.081 – 1.438), history of gynecological diseases (yes vs. no: OR = 1.301, 95% CI: 1.136 – 1.490), menopause (yes vs. no: OR = 2.354, 95% CI: 1.712 – 3.238); no significant impact of pregnant and childbirth history on FSD were observed. Conclusion The incidence rate of FSD in China is high, which affects the quality of life and mental health of women. It is of great significance to promote the health of women in groups and reproductive health according to the cause of disease and intervention. -
表 1 调查人群一般资料概况(n = 14 306)
特征 调查人数 百分比(%) 年龄(岁) 18~29 2513 17.57 30~39 6831 47.75 40~49 3334 23.30 50~59 1358 9.49 60~69 270 1.89 文化程度 初中及以下 3053 21.34 高中/中专-大专 5687 39.75 本科及以上 5566 38.91 职业 医疗相关行业 4185 29.25 服务行业 1263 8.83 销售行业 2184 15.27 教师/行政行业 3033 21.20 工人 541 3.78 农民 1020 7.13 家庭主妇 1093 7.64 大学生 987 6.90 婚姻状况 未婚(有性生活) 2791 19.51 已婚 11515 80.49 生育情况 未生育 4687 32.76 已生育 9619 67.24 家庭人均月收入(元) > 5 000 6279 43.89 3 000~5 000 5365 37.50 1 000~2 999 2046 14.30 < 1 000 616 4.31 基础疾病 无 11900 83.18 有 2406 16.82 地域分布(前4) 安徽省 8762 61.25 北京市 1167 8.16 山西省 462 3.23 江苏省 378 2.64 分娩史 顺产 6887 71.60 剖宫产 2732 28.40 分娩次数 1 4264 44.33 2 3871 40.24 ≥ 3 1484 15.43 是否绝经 是 1026 7.17 否 13280 92.83 妇科疾病 有 1544 10.79 无 12762 89.21 高血压 2097 14.66 糖尿病 2852 19.94 高血压合并糖尿病 812 5.68 口服抗抑郁药物 1022 7.14 吸烟 1394 9.74 表 2 调查人群FSFI评分及患病情况
维度 得分(分) 患病例数(例) 患病率(%) 性欲望 3.43 ± 0.79 6605 46.17 性唤起 3.73 ± 0.96 4528 31.65 阴道润滑 4.65 ± 0.88 3237 22.63 性高潮 4.26 ± 0.84 4359 30.47 性满意度 4.16 ± 0.87 6720 46.97 性交痛 4.33 ± 0.97 4853 33.92 FSFI总分 24.43 ± 4.36 7606 53.17 表 3 不同年龄调查人群FSFI总评分及各维度评分比较
年龄(岁) 总分 性欲望 性唤起 阴道润滑 性高潮 性满意度 性交痛 18~29 26.69 ± 3.77 3.67 ± 0.91 4.01 ± 0.89 4.76 ± 0.85 4.64 ± 0.67 4.83 ± 0.81 4.61 ± 1.06 30~39 25.73 ± 3.49 3.71 ± 0.87 3.88 ± 0.97 4.56 ± 0.79 4.43 ± 0.69 4.31 ± 0.80 4.57 ± 0.88 40~49 24.01 ± 3.79 3.27 ± 0.73 3.74 ± 0.87 4.53 ± 0.86 4.42 ± 0.79 3.96 ± 0.93 4.66 ± 0.89 ≥ 50 20.43 ± 4.33 2.59 ± 0.92 2.86 ± 0.99 3.75 ± 0.96 3.49 ± 0.86 3.23 ± 1.11 4.34 ± 0.95 F 值 361.574 269.968 340.003 271.017 231.896 236.065 107.057 P 值 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 表 4 不同特征调查人群FSFI总评分及各维度评分比较
变量 总分 性欲望 性唤起 阴道润滑 性高潮 性满意度 性交痛 文化程度 初中及以下 22.67 ± 3.89 3.23 ± 0.77 3.42 ± 0.76 4.39 ± 0.81 4.16 ± 0.81 4.04 ± 0.83 4.33 ± 0.94 高中/中专 – 大专 23.54 ± 3.71 3.31 ± 0.81 3.63 ± 0.74 4.59 ± 0.78 4.29 ± 0.76 4.11 ± 0.87 4.49 ± 0.87 本科及以上 25.11 ± 3.29 3.36 ± 0.74 3.88 ± 0.82 4.81 ± 0.84 4.31 ± 0.72 4.27 ± 0.83 4.60 ± 0.91 F 值 92.501 18.597 66.876 118.821 83.518 121.343 10.391 P 值 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 职业 体力劳动 23.22 ± 4.22 3.27 ± 0.76 3.53 ± 0.82 4.36 ± 0.87 4.21 ± 0.77 3.86 ± 0.77 4.32 ± 1.02 非体力劳动 25.69 ± 4.14 3.38 ± 0.81 3.73 ± 0.92 4.72 ± 0.74 4.43 ± 0.81 4.26 ± 0.90 4.59 ± 0.91 t 值 – 5.624 1.004 – 5.117 – 8.008 – 5.202 – 7.616 – 2.163 P 值 < 0.001 0.276 < 0.001 < 0.001 < 0.001 < 0.001 0.038 人均月收入(元) < 3 000 23.79 ± 4.13 3.01 ± 0.87 3.57 ± 0.83 4.32 ± 0.91 4.06 ± 0.81 3.91 ± 0.92 4.37 ± 0.92 3 000~5 000 24.37 ± 4.23 3.36 ± 0.69 3.69 ± 0.81 4.55 ± 0.86 4.22 ± 0.83 4.03 ± 0.88 4.41 ± 0.86 > 5 000 25.11 ± 4.07 3.31 ± 0.77 3.78 ± 0.90 4.69 ± 0.91 4.37 ± 0.79 4.34 ± 0.84 4.67 ± 0.95 F 值 13.982 5.493 13.467 29.735 11.519 16.477 6.826 P 值 < 0.001 0.004 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 绝经情况 未绝经 25.08 ± 3.67 3.32 ± 0.83 3.79 ± 0.76 4.71 ± 0.83 4.39 ± 0.83 4.09 ± 0.82 4.61 ± 0.91 已绝经 21.22 ± 4.25 2.57 ± 0.91 2.84 ± 0.82 3.67 ± 0.87 3.96 ± 0.76 3.19 ± 0.94 4.11 ± 0.87 t 值 22.463 20.175 24.524 22.732 22.469 20.361 10.031 P 值 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 妇科疾病 无 25.21 ± 3.96 3.43 ± 0.76 3.69 ± 0.81 4.49 ± 0.76 4.03 ± 0.79 4.28 ± 0.91 4.61 ± 0.94 有 21.42 ± 4.03 2.87 ± 0.83 3.01 ± 0.86 3.81 ± 0.82 3.57 ± 0.62 3.47 ± 1.01 4.27 ± 1.09 t 值 10.712 8.363 9.964 8.613 5.251 8.631 3.221 P 值 < 0.001 < 0.001 < 0.001 < 0.001 0.002 < 0.001 0.003 糖尿病 无 24.97 ± 4.11 3.41 ± 0.91 3.81 ± 0.76 4.42 ± 0.93 4.22 ± 0.87 4.33 ± 0.90 4.42 ± 0.89 有 21.45 ± 4.58 2.47 ± 0.89 2.97 ± 0.98 3.79 ± 0.99 3.59 ± 0.91 3.61 ± 1.03 4.37 ± 0.92 t 值 4.363 5.014 4.313 4.680 2.093 2.653 0.633 P 值 < 0.001 < 0.001 < 0.001 < 0.001 0.037 0.043 0.547 表 5 FSD相关影响因素logistic回归分析
变量 参照组 β $S_{\bar x}$ χ2 值 P 值 OR 值 95 % CI 年龄 ≥ 30岁 18~29 0.629 0.096 14.976 < 0.001 1.875 1.553~2.265 文化程度高中及以上 初中及以下 – 0.306 0.116 9.522 0.008 0.737 0.587~0.924 职业为非体力劳动 体力劳动 0.173 0.073 13.122 0.018 1.189 1.030~1.373 月收入(元) < 3000 0.221 0.075 13.170 0.002 1.247 1.081~1.438 已生育 否 0.030 0.176 3.706 0.864 0.970 0.687~1.370 分娩方式为剖腹产 顺产 0.047 0.084 1.003 0.571 1.049 0.890~1.236 分娩次数 > 1次 1次 0.204 0.129 2.236 0.114 1.226 0.952~1.578 绝经情况 否 0.856 0.163 7.523 < 0.001 2.354 1.712~3.238 妇科疾病 无 0.263 0.069 6.970 < 0.001 1.301 1.136~1.490 吸烟 否 0.234 0.192 0.162 0.222 1.264 0.868~1.841 高血压 无 0.339 0.173 3.973 0.050 1.404 1.000~1.971 糖尿病 无 0.687 0.219 14.344 0.002 1.987 1.294~3.052 -
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