Gebelerde cinsel fonksiyon değerlendirmesi: Serum androjen ve fetal cinsiyet ilişkisi

Öz

Giriş: Hamilelik sırasında fiziksel ve hormonal değişiklikler sonucunda kadınların cinsel sağlığı önemli derecede etkilenmektedir.

Amaç: Hamile Türk kadınlarda cinsel değişiklikler ile androjenik hormonlar ve fetal cinsiyet ilişkisini değerlendirmek.

Metod: Bu kesitsel çalışma Kadın Hastalıkları ve Doğum Kliniği'nde değerlendirilen 194 sağlıklı gebeyi içermektedir. Gebe kadınlar, Kadın cinsel işlev ölçeği(KCİÖ) ve sosyodemografik özelliklerle ilgili sorular  içeren ,kendi kendine uygulanan bir anket doldurdu. Serum androjenleri aynı zamanda çalışıldı. FSFI toplam ve altgrup  puanları, maternal serum total testosteron , dehidroepiandrosteron sülfat(DHEAS) ve 1-4 delta androstenedion düzeyleri ölçüldü.

Bulgular: Türk gebe kadınlarda %68 oranında cinsel işlev bozukluğu bulundu. Cinsel işlev bozukluğu oranı, gebelik boyunca KCİÖ'nin toplam ve altgrup puanlarını içerir. KCİÖ'nin toplam ve altgrup puanları trimesterlar arasında farklılık göstermese de , gebelik haftası ilerledikçe orgazm altgrup puanının azaldığı bulundu. Bunun yanında gebelik haftası ilerledikçe toplam testosteron artışıyla beraber DHEAS düzeyinin azaldığı görüldü. Kız fetüslü kadınlarda KCİÖ puanları ve trimesterlar arasında androjen düzeyleri değerlendirildiğinde, üçüncü trimesterdaki total testosteron düzeyi ,birinci ve ikinci trimester düzeylerinden daha yüksek bulundu. Ayrıca ilk trimesterdaki DHEAS düzeyleri ikinci ve üçüncü trimester seviyelerinden  yüksek bulundu. Erkek fetüsü olan kadınlarda trimesterlar arasında androjen düzeyleri, KCİÖ toplam ve altgrup puanları açısından anlamlı bir fark yoktu.

Sonuç: Türk gebe kadınlarda yüksek bir cinsel işlev bozukluğu oranı (%68) bulundu. Toplam testosteron, DHEAS ve KCİÖ orgazm altgrup skorunun trimesterlar arasında farklılık gösterdiği bulundu. Sağlık hizmeti sunanlar antenatal muayenelerde cinsel sağlık konusunda  danışmanlık için daha çok zaman ayırmalı ve cinsel sağlık ve sorunlar hakkında konuşmak için gebeleri teşvik etmelidirler.

Anahtar Kelimeler

• Cinsel sağlık,gebe,androjen,fetüs

Assesment of female sexual function of pregnant women: Relation with serum androgens and fetal gender

Abstract

Introduction: As a result of physical and hormonal changes during pregnancy sexual health of women affected significantly.

Aim: To evaluate sexual changes related to androgenic hormones and fetal gender in pregnant Turkish women.

 Methods: This cross-sectional study included 194 healthy pregnant women evaluated at Obstetrics and Gynecology Clinics. Pregnant women completed a self-administered questionnaire including  the Female Sexual Function Index (FSFI) and questions related to socio-demographic characteristics. Serum androgens were run simultaneously.

Main outcome measures: FSFI total and domain scores , the level of maternal serum total testosterone, Dehydroepiandrosterone sulphate (DHEAS) and 1-4 delta androstenedione  were measured.

Results: There was a rate of 68%  sexual dysfunction among Turkish pregnant women. The sexual dysfunction rate comprises the total and domain scores of FSFI throughout the pregnancy. Although the total and domain scores of FSFI did not differ between trimesters, orgasm domain scores were found to be  decreasing with increasing gestational age. Along with an increase in total testosterone, the DHEAS level decreases with increasing gestational age. When the women with female fetus were evaluated for FSFI scores and androgen levels between trimesters, the mean level of total testosterone in third trimester was higher than the levels of first and second trimesters besides the mean level of DHEAS in the first trimester was higher than the levels of second and third trimesters. There was not any significant difference according to the androgen levels, FSFI total and domain scores between trimesters of the women with male fetus.

Conclusion: We found a high sexual dysfunction rate (68%) among pregnant Turkish women. The level of total testosterone, DHEAS and FSFI orgasm domain were found to be different between trimesters. Healthcare providers should provide more time for counseling about sexuality and encourage pregnant women to talk about sexual health and problems during antenatal visits.

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