Procena uticaja gojaznosti na kvalitet života i seksualnost u menopauzi

Abstract

Cilj rada: Ispitati uticaj gojaznosti i pridruţenih bolesti na kvalitet ţivota i seksualnost kod ţena u menopauzi. Metode: Studijom su obuhvaćene 73 ţene u menopauzi koje su podeljene u dve grupe: gojazne ţene (osnovna grupa, inteks telesne mase (ITM) ≥ 26.7 kg/m2) i normalno uhranjene ţene (kontrolna grupa, ITM < 26.7 kg/m2). Svim ispitanicama su merene antropometrijske karakteristike i krvni pritisak. Krv je uzima u 08:00 za: glikemiju našte, trigliceride, ukupni holesterol, HDL holesterol, LDL holesterol, apolipoprotein A (Apo A), apolipoprotein B (Apo B), lipoprotein(a) (Lp(a)), C-reactivni protein (CRP), fibrinogen, folikulostimulišući hormon (FSH), luteinizirajući hormon (LH), estradiol (E2), prolactin (PRL), progesteron (P), testosteron (T), polni hormon – vezujući globulin (SHBG), androstenedion (AD), 17-Hidroksiprogesteron (17OHP) i dehidroepiandrosteron sulfat (DHEAS). Sve ispitanice su popunjavale dva uputnika: McCoy upitnik o seksualnom ţivotu ţena (MFSO) i generički upitnik za ispitivanje kvaliteta ţivota - SF-36. Rezultati: Gojazne ţene su imale statistički značajno više vrednosti starosti, antropometrijskih parametara, trajanja menopauze, sistolnog i dijastolnog krvnog pritiska, E2 i CRP – a. Normalno uhranjene ţene su imale statistički značajno više vrednosti FSH, LH, SHBG – a, ukupnog i LDL holesterola. MFSO upitnik je pokazao da gojazne ţene značajno manje osećaju bol tokom seksualnog odnosa u odnosu na normalno uhranjene ţene. Ukupan skor za gojazne ţene je bio 3.48, a za kontrolnu grupu 4.09 od mogućih 7. Rezultati SF–36 upitnika su pokazali da nema značajne razlike u kvalitetu ţivota meĎu ispitivanim grupama. Konačan skor za fizičko zdravlje kod gojaznih ţena je iznosio 45.39, a kod normalno uhranjenih 48.12 od mogućih 100. Kada je u pitanju mentalno zdravlje, ukupan skor za gojazne ţene je iznosio 48.04, a za kontrolnu grupu 42.95. U osnovnoj grupi statistički značajne negativne korelacije su utvrĎene izmeĎu: HDL holesterola i zadovoljstva partnerom kao ljubavnikom, sistolnog krvnog pritiska i ograničenja zbog fizičkog i mentalnog zdravlja; značajne pozitivne korelacije testosterona sa uzbuĎenjem, učestalošću orgazma, nedovoljnom vaginalnom lubrikacijom i zadovoljstvom partnerom kao ljubavnikom i estradiola sa opštim zdravljem, ograničenjima zbog emocionalnih problema, telesnim bolovima i emocionalnim blagostanjem...

Objective: To assess influence of obesity and related disturbances on sexuality and quality of life (QoL) in the menopause. Methods: The study included 73 women in the menopause, who where divided into groups: obese (BMI ≥ 26.7 kg/m2) and controls (BMI < 26.7 kg/m2). Anthropometric characteristics and blood pressure were measured. Blood was taken at 08:00 for fasting glucose, triglycerides, total cholesterol, HDL cholesterol, LDL cholesterol, apolipoprotein A (Apo A), apolipoprotein B (Apo B), lipoprotein(a) (Lp(a)), C-reactive protein (CRP), fibrinogen, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2), progesterone, testosterone, sex hormone binding globulin (SHBG), androstenedion (AD), 17- Hydroxyprogesterone (17OHP) and dehydroepiandrosterone sulfate (DHEAS). All the participants filled in two questionnaires: McCoy Female Sexual Questionnaire (MFSO) and SF- 36 questionnaire for the assessment of Quality of Life (QoL). Results: Obese women have had significantly higher values of age, anthropometric parameters, time since menopause, sistolic and diastolic blood pressure, E2 and CRP. Controls have had significantly higher values of FSH, LH, SHBG, total and LDL cholesterol. Related to McCoy questionnaire obese women have had less frequent pain during sexual intercourse. Total score for obese women was 3.48, while for controls 4.09 (maximum was 7). SF-36 questionnaire showed that there was no significant difference in the quality of life between two groups. Total score for physical health in obese women was 45.39, while in controls 48.12 (maximum was 100). Total score for mental health in obese participants was 48.04, while for controls 42.95. In basic group statistically significant negative correlations were found between: HDL cholesterol and satisfaction with partner as a lower, sistolic blood pressure and limitation due to physical and emotional health; significant positive correlations of testosterone with arousal, freqency of orgasm, insufficient vaginal lubrication and satisfaction with partner as a lower; significant positive correlations of estradiol with general health, limitation due to emotional health and pain. In controls statistically significant negative correlations were found between waist and frequency of orgasm, between triglycerides, general health and social functioning; significant positive correlations of glicaemia with pain and between estradiol and limitation due to emotional health. Very significant influence of age on frequency of sexual intercourse exists in all participants...