Sexuality in women with polycystic ovary syndrome
7
0
0
Pełen tekst
(2)
(3)
(4)
(5) 3
(6) ! " # 1. Department of Sexology, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland Department of Public Health, Warsaw Medical University, Warsaw, Poland 3 Department of Women’s Disease Control and Prevention, School of Health Care, Medical University of Silesia, Katowice, Poland 4 Department of Sexology and Family Planning, Medical Collage in Sosnowiec, Poland 5 Faculty of Psychosocial Basis in Rehabilitation, Department of Social Problems, Psychotherapy and Sexual Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Poland 2. Abstract Objectives: This study aimed to compare sexual function and sexual response, attitude toward sexuality, and relationships with sexual partners in women diagnosed with PCOS and healthy controls. Material and methods: The study included 73 women (aged 23–42 years) diagnosed with PCOS using the Rotterdam criteria and 45 healthy controls. All participants completed a questionnaire assessing socioepidemiological parameters and sexual behavior. Validated instruments were used to assess hirsutism (Ferriman-Gallwey Scale), mental health status (General Health Questionnaire 12 [GHQ 12]), sexuality (Sexuality Scale [SS], Sexual Awareness Questionnaire [SAQ], Multidimensional Sexuality Questionnaire [MSQ], Multidimensional Sexual Self-Concept Questionnaire [MSSCQ]), and sexual function (Polish version of the Mell-Krat Scale [SFK/K Scale]). Results: There were no statistically significant differences in the importance of sexual activity in both groups. Mean scores for the SFK/K Scale, SS, SAQ, MSQ, and MSSQ were similar among women with PCOS and controls, regardless of age. Similarly, sexual needs and reactions were perceived in the same way by both groups. In contrast, women with PCOS rated themselves negatively as sexual partners more frequently than controls. Conclusions: Sexual function and sexual response, attitude toward sexuality, as well as relationships with sexual partners were similar in PCOS subjects and healthy women. However, changes in physical appearance typically associated with PCOS result in deterioration of sexual function. Therefore, it is recommended that all PCOS patients should be referred to a sexual medicine specialist for consultation.. Key words: polycystic ovary syndrome / sexuality / sexual function / sexual reactions / / attitudes / Streszczenie Cel pracy: Celem pracy było porównanie funkcji seksualnych i reakcji seksualnych, postawy wobec seksualności, oraz relacje z partnerem seksualnym u kobiet, u których zdiagnozowano zespołem jajników policystycznych (PCOS) i kobiet zdrowych.. Corresponding author: Robert Kowalczyk Department of Sexology, Andrzej Frycz Modrzewski Krakow University, ul. Gustawa Herlinga-Grudzińskiego 1, 30-705 Kraków, Poland Phone: +48 12 252 46 20, Fax: +48 12 252 46 51 e-mail: kowalczyk.robert@wp.pl. 100. © Polskie Towarzystwo Ginekologiczne. Otrzymano: 03.05.2014 Zaakceptowano do druku: 17.08.2014. Nr 2/2015.
(7) Ginekol Pol. 2015, 86, 100-106. P R A C E. O R Y G I N A L N E g i n e kol og i a. Robert Kowalczyk et al. Sexuality in women with polycystic ovary syndrome.. Materiał i metody: Badaniami objęto grupę 73 kobiet w wieku 23-42 lat, u których zdiagnozowano PCOS wg kryteriów Rotterdamskich oraz grupę kontrolną – 45 zdrowych kobiet. Wszyscy uczestnicy badania wypełnili kwestionariusz zawierający pytania dotyczące parametrów demograficznych, społeczno-kulturowych oraz zachowań seksualnych. Ponadto zastosowano walidowane narzędzia do oceny: hirsutyzmu (Skala FerrimanGallwey), stanu zdrowia psychicznego (Kwestionariusze Ogólnego Stanu Zdrowia – GHQ 12), seksualności: Test Postaw Wobec Seksualności – SS, Test Seksualnej Samoświadomości - SAQ, Wielowymiarowy Test Seksualności – MSQ, Wielowymiarowy Test Seksualnego „Ja” – MSSCQ oraz funkcji seksualnych (polska wersja Mell-Krat Scale – SFK/K). Wyniki: Nie stwierdzono statystycznie istotnych różnic w znaczeniu aktywności seksualnej dla badanych kobiet w obu grupach. Średnie uzyskanych wyników dla skal: SFK/K, SS, SAQ, MSQ i MSSCQ były podobne u kobiet z PCOS i tych z grupy kontrolnej niezależnie od wieku. Podobnie, potrzeby seksualne i reakcje były postrzegane w taki sam sposób w obu grupach. Natomiast kobiet z PCOS oceniały siebie gorzej w roli partnerek seksualnych w porównaniu do zdrowych. Wnioski: Funkcje seksualne i reakcji seksualne, postawy wobec seksualności, a także relacje z partnerem seksualnym były podobne u osób z PCOS i zdrowych kobiet. Jednakże zmiany w wyglądzie fizycznym występujące u kobiet z PCOS mogą powodować pogorszenie funkcji seksualnych. Dlatego też zaleca się, aby wszyscy pacjenci z PCOS byli kierowany na konsultacje do specjalistów z dziedziny medycyny seksualnej.. Słowa kluczowe:
(8)
(9) / / funkcje seksualne / / reakcje seksualne / postawy /. Introduction $%
(10) &
(11) %
(12) % '
(13) ! ( &
(14) ' &
(15) ' ) * (
(16) !
(17) &
(18) %
(19) + ! ((%
(20) ,
(21) , %
(22) , ' %% % ) -(% .'% %
(23) &
(24) )) &
(25) ' '
(26)
(27) &
(28)
(29) ( . %/ &
(30) (
(31) () ' ( , ( ( %
(32) &
(33) , , (
(34)
(35) ' ''
(36) !
(37) 0
(38) '! (%
(39) 1
(40) &
(41) '
(42) ( 245)
(43) , '%0671 ( ' , (%
(44) '' ( !
(45) '! ( %
(46) (
(47) % (
(48) % '+ ! ' '( '! %2 #5) -(
(49) ( &
(50) % ( 67) 8 , ' &
(51) ' ( &
(52) % ( 67 ' ' ) *
(53) (!(
(54) ,
(55) 67 ( (
(56) ' !! (!(
(57) ' ( '! % ' ( % ( , ' ' &
(58) ' 29 :5) %
(59)
(60) ' ; '
(61)
(62) ) ( ,' ! , ( % !
(63)
(64)
(65) ! '%
(66) &
(67)
(68) '
(69) ''( 67' '(+
(70)
(71) '%
(72) &
(73) ! ( ' %2<5)8 (
(74) ) '(,
(75)
(76) !
(77) 0*1 &
(78) ' ( ' (
(79) (!( (67 '(
(80) ( %( '( % ' + &
(81) % ( 67 !=
(82)
(83) =' ( ( &
(84) ' '(%
(85) ,
(86) ,( ((
(87) ( 2>?5) @ ( % (
(88) (' ( ( ('
(89) '! &
(90) . ( ( ! (
(91)
(92)
(93) ' & ,'( (% % ' % (
(94) !
(95)
(96) % ' (6725). Nr 2/2015. *
(97) (!((' ! 67% ( , ! ,% &
(98)
(99) ( ' &
(100) (
(101) (%
(102) A' ( ! ' (
(103) !
(104) &
(105)
(106) % '%!(' % ,''( ' % '25)$(% '( '% ' &
(107) %
(108) % (67 '(
(109) (
(110) & ( ! % A %
(111) B 67. % %
(112)
(113)
(114) % ( 245) $( ( ,
(115) ( &
(116) ' &
(117) % (67)8 , ' ' ( % (67
(118) !% ''(
(119) !C %'/
(120) ! %%
(121) '
(122) 25)-( (+ (
(123) !
(124) ''
(125) ' '
(126) (( %) 7 ! ( (
(127)
(128) ( 67 &
(129) '' &
(130) ! ( ' ',
(131) ' ' % )-( ' ,
(132) (,
(133) &
(134) ' ('%( ( &
(135) &
(136) ' ' ' &
(137) %. (67). Objectives -( ' %' % %' ! ' (67 '(
(138) (
(139) ( &
(140) &
(141) ' ' &
(142) '
(143) ( ( &
(144) ). Materials and methods Study population and recruitment @
(145) :< %
(146)
(147) ' (
(148) ' ' ' D (??> '%??>)-( ' ,' ( E(
(149) 6%% ( D'
(150) F,
(151) 0 ,
(152) )G")') 9#?B>A H %>?? 1)*
(153)
(154) !' %' ( '). © Polskie Towarzystwo Ginekologiczne. 101.
(155) Ginekol Pol. 2015, 86, 100-106. P R A C E O R Y G I N A L N E ginekolog i a. Robert Kowalczyk et al. Sexuality in women with polycystic ovary syndrome.. -( , ! ' !
(156)
(157) ' < % !' 4B ' ! ' ( 67 ! ( ' % 2?5) ' '
(158) ' % %!. % ( ' ! ' '(
(159) ' (; % I
(160) ! J'
(161) ! D'
(162) F,
(163) ) -(
(164)
(165)
(166) G ' ! 67 '!(' % ! 4B (
(167) !
(168) ' ' 0 '( K4(I
(169) 8
(170) ( L 2I8L51 ' ) ,! '! ( (
(171) ' 0 ' , ( ,'! , ' ( % 1 % . !
(172) !
(173) 0( % ( % % %1 &
(174) '' %( '0M<1)J
(175) , ' ( ')N% ( ' K4 I8L
(176) &
(177) '' (
(178) ! ! ' (' ! (& ! (
(179) !
(180) ' ' ( (
(181) !
(182) ' '
(183) ' '(
(184) ( ')$
(185)
(186) :4 % (67.
(187) ''( '!) -(
(188) ! ' #?(
(189) ( %% (' '%! ( =
(190) ( '' % ( 67 ' ' %!
(191) !
(192)
(193) (N%/ 8
(194) (; ! 6
(195) ' (% (
(196) !
(197) !
(198) ( )-(
(199)
(200) !&
(201)
(202) 'G( (
(203) !
(204) ' ' ( ' ' 0 ' I8L K41 !O4K , % ' ( '' ' %
(205)
(206)
(207) ,' ( % .!
(208) !
(209) 0( %( % % %1 %' ! &
(210) 0 ( ( , ' ( % '
(211) , 1! (4 %( % '
(212) &
(213) 0'=' ( = ! !%
(214) , !
(215) &
(216) ','
(217) /
(218) 1)$, %
(219) ' %
(220) (+
(221)
(222) ' &
(223) '' % ( ') $
(224)
(225) # (
(226) (. %
(227) ''(
(228) !). Methods *
(229)
(230) %
(231) ' ?% + ' !'
(232)
(233) ( ( ' ! '%
(234) !
(235) % ' &
(236) ( ,
(237) '! ! = &
(238)
(239) % &
(240) !
(241) &
(242) ,,( ( ' &
(243) ' &
(244) , %')
(245) ' ' % ' ( % 0$% I
(246)
(247)
(248) 1%
(249) (
(250) ( 0I8L1 &
(251) 0&
(252)
(253) 25&
(254) * L 2*L5D
(255) '%
(256) &
(257) L 0DL1 ' D
(258) '%
(259) &
(260)
(261) 6 L 2D6L51 ' &
(262) 0
(263) (, (D
(264)
(265)
(266) 2$ A
(267) 51). Instruments -( $% I
(268)
(269)
(270) ' ,
(271) ! ' + !( %(
(272)
(273) !>
(274) G(
(275) (
(276) '%
(277) ' % % '(!( 2 5 (( O: C%
(278) / <B C%' / ' B49 C ,/( %2 #5) -(I8L ' '
(279) %
(280) (
(281) ( '' ( (%
(282)
(283)
(284) + ' =
(285)
(286) % %
(287)
(288)
(289)
(290)
(291) ( ',
(292) ! ( ' ' )* K4 ' ( ''
(293) ' ! ' =%. 102. &
(294) '( ( ' ' 295)-( ' ! + !
(295) ) * %'=' , ( + ( ( ( % (% ',
(296) ' (6 7
(297) (
(298) ! ( @ 7
(299) D' "'295) -($ A
(300) ',
(301) &
(302) ' ' )-(+ ?% ' %? )-(%%
(303) '% &%
(304)
(305) ? '<? ,
(306) ((!( '! &
(307) ) * K## ,' C%
(308) /)-(
(309) (
(310)
(311) (6 (/ PM?)9>2:<5) -( . ,
(312) % ' !' % ( (% &
(313) G &
(314) %B' =' ,! ' ' =' ( & / &
(315) ! '.
(316) H &
(317) ' B '='
(318) ! ' ( ' ' ! '!Q &
(319) H ' &
(320) B '=' (' ( & & ,'!) -(+ 4?% !' % (
(321)
(322) ' ' ( % (( !0' !1. (( %)*#"
(323) ' ' ' %?0 !1 0' !1)8!( , ' ! !% ( ( % ( % ! , ' ! ' !% ( ( % )-(
(324) (
(325)
(326) (6 (/ P M?)<<R?)> %/ %
(327) 2>5) -(*L . ,
(328) + ! 49% ' !'%
(329) ' ' ( &
(330) ' &
(331) , )8!( ' ! % (
(332) , ' ) -(
(333) '
(334)
(335)
(336) ( , ( ( ,
(337)
(338)
(339) (6 (/ PM?)<4R?)> %/ %
(340) 25) -(DL . ,
(341) %' !' %
(342) , (% &
(343) ) -( + 9?% ' ! #"
(344) )8!( (DL ' ! '! (
(345) , ' )-( DL ( '% ' ( ,
(346)
(347)
(348) (6 (/ PM?):R?)> %/ %
(349) 245) -(D6L . ,
(350) %' !' % (
(351) !
(352) (% &
(353) )-( + ??% ' ! #"
(354) )-(6 (/ P (?
(355) ! %?): ?)> ' ! '+
(356) 2 5) *
(357)
(358) % ( , ,
(359) ' ' (
(360) (
(361) ). Demographic and sexual activity measurements E'% '&0ED@10!A%21
(362)
(363) '% '% A(!(2)&
(364) , '=' (
(365)
(366) !G !
(367) % , !
(368)
(369)
(370) &)&
(371) '=' (
(372)
(373) %
(374) &
(375) (. , ' . ,
(376) '! &
(377)
(378) &
(379) ' ! % ' &
(380) 245) *' ' &
(381) '
(382) ( ( &
(383) % , ' ! ! ) ' ( , ,
(384) ' ( % ' 4? ! %
(385) ' ( &
(386) ' ( % , 4? % ' ( %
(387) ' %((' 2#5). © Polskie Towarzystwo Ginekologiczne. Nr 2/2015.
(388) Ginekol Pol. 2015, 86, 100-106. P R A C E. O R Y G I N A L N E g i n e kol og i a. Robert Kowalczyk et al. Sexuality in women with polycystic ovary syndrome.. Table I. General characteristic of the studied population – sociodemographic and sexuality-related factors. PCOS 1 (n=51). Controls 1 (n=15). p*. PCOS 2 (n=22). Controls 2 (n=30). p*. Age - years (mean, SD, range). 26.2±2.3 (23-30). 25.5±1.9 (23-29). NS. 36.8±3.3 (31-42). 36.7±2.8 (32-42). NS. BMI (mean, SD, range). 24.2±5.6 (15.8-44.6). 21.6±3.9 (16.4-33.9). NS. 26.1±5.6 (19.6-38.1). 24.0±4.1 (18.5-38.9). NS. F-G scale (mean, SD, range). 6.7±6.2 (0-20). 4.7±4.3 (0-12). 0.01. 7.5±7.0 (0-20). 3.3±3.9 (0-13). 0.001. GHQ-12 (mean, SD, range). 14.6±6.8 (0-32). 13.4±6.5 (4-25). NS. 15.5±8.0 (6-35). 12.4±5.9 (0-24). NS. Variable. Marital status (N,%) Married/Partnership. 23 (45.1). 5 (33.3). NS. 16 (72.7). 19 (63.3). NS. Single. 27 (52.9). 10 (66.7). NS. 6 (27.3). 11 (36.7)). NS. 3 (5.9). 0 (0.0). NS. 2 (9.1). 0 (0.0). NS. Secondary. 20 (39.2). 5(33.3). NS. 7 (31.8). 14 (46.7). NS. Tertiary. Education (N,%) Primary. 28 (54.9). 10 (66.7). NS. 13 (59.1). 16 (53.3). NS.
(389) – years (mean, SD, range). 18.9±18 (15-21). 18.6±1.6 (16-21). NS. 19.4±1.8 (15-21). 19.4±1.4 (17-21). NS. Sexually active during the last 4 weeks † (N,%). 46 (90.2). 14 (93.3). NS. 20 (90.9). 28 (93.3). NS. No. of sexual partners in their lifetime (median, upper/lower quartile). 1.0 (1.0-3.0). 2.0 (1.0-4.0). NS. 2.0 (1.0-4.0). 2.0 (1.0-4.0). NS. Having a regular sexual partner (N,%). 36 (70.6). 12 (80.0). NS. 17 (77.7). 24 (80.0). NS. Type of performed sexual activity (N,%) Penile-vaginal. 43 (93.5). 13 (92.8). NS. 19 (86.4). 27(93.1). NS. Oral. 26 (56.9). 10 (73.3). 0.01. 10 (50.0). 12 (41.4). NS. Anal. 4 (8.7). 1 (7.1). NS. 0 (0.0). 1 (3,4). NS. 20 (43.5). 4 (28.6). 0.02. 7 (35.0). 12 (41.4). NS. Masturbation. * ch2 test/Fisher’s exact test for the qualitative variables; Mann-Whitney U test for the quantitative variables †Sexual activity defined as any of the following: caressing, foreplay, masturbation and vaginal intercourse; F-G scale – Ferriman-Gallwey scale; SD – standard deviation. -( 67 '
(390) ','' !''! 6704B4? 1 '6704B 1
(391) 04B4? 1 '
(392) 04B 1). Statistical analysis -( '
(393)
(394) '
(395)
(396) ( <)?0
(397) '1) ; %
(398) ' ( %
(399)
(400) % D BN(F . ' (
(401) + ,,
(402) '
(403) (%! , )-(
(404)
(405) ! ' ( +
(406) ,,
(407) G ( + '$ (/ & 0 ( %
(408)
(409) ( +
(410) ?1)-( '
(411) ,
(412) =' O?)?#). Results D ! ( :)9T9)4 ' 44)?T#)> 67 . '
(413) ,
(414) )-(
(415)
(416) != ' ( ! . ( % ,
(417) '!
(418) (
(419) ( )-($% I
(420)
(421)
(422)
(423) !=
(424) (!( % (67(
(425) ( !! 0-
(426) @1) Nr 2/2015. &
(427) , % &%
(428) % ( % . ' (67 '
(429) ! B
(430)
(431) % ' ,') % & &
(432) , '> %(67! '
(433) )-( ' ( &
(434) 67 '
(435) & ( % ( 67 '(%
(436) , ! ,
(437) &
(438) % +
(439) (
(440)
(441) ( ! O4? !0-
(442) @@1)*,
(443)
(444) ,' % K4? !'' (
(445) != ) %
(446)
(447) %O4? ( '' &
(448) , (! G (67 %
(449)
(450) ! !% (
(451) & % + (
(452) !)-( ' ,' % K4?0-
(453) @@1) D (
(454) ( %
(455) % (67 '
(456) ((& 01 &
(457) ' %O4? '01 &
(458) . %K4?)@( %! (67( '
(459)
(460) (!(
(461) ,
(462) &
(463) ' ( (
(464) !67 ( '
(465)
(466) (!(
(467) ,
(468) &
(469) ( !% ('
(470) 0-
(471) @@1). © Polskie Towarzystwo Ginekologiczne. 103.
(472) Ginekol Pol. 2015, 86, 100-106. P R A C E O R Y G I N A L N E ginekolog i a. Robert Kowalczyk et al. Sexuality in women with polycystic ovary syndrome.. Table II. Sexual functions, sexual response and attitude towards sexuality in the studied population. Variable SFK/K (mean, SD, range). PCOS 1 (n=51). Controls 1 (n=15). p*. PCOS 2 (n=22). Controls 2 (n=30). p*. 49.3±10.7 (20-76). 52.2±7.1 (37-61). NS. 50.2±11.8 (25-67). 50.6±8.3 (29-62). NS. Sexuality scale (mean, SD, range) Sexual Esteem. 32.8±7.1 (16-64). 36.1±5.1 (25-42). NS. 34.8±5.9 (19-45). 33.7±6.1 (18-45). NS. Sexual Depression. 18.4±6.2 (8-31). 14.0±4.9 (8-25). 0.02. 17.2±6.5 (8-30). 16.3±6.4 (8-33). NS. Sexual Preoccupation. 26.9±5.5 (18-43). 29.4±5.1 (19-39). NS. 29.3±6.8 (14-40). 23.3±6.1 (16-40). 0,02. Sexual Awareness Questionnaire (mean, SD, range) sexual-consciousness. 20.9±4.2 (12-29). 22.7±4.4 (14-28). NS. 20.2±5.3 (7-30). 21.5±3.8 (13-29). NS. sexual-monitoring. 22.3±3.4(16-32). 22.5±3.8 (14-28). NS. 22.9±1.9 (19-27). 21.1±3.4 (14-27). NS. sexual-assertiveness. 17.7±3.6(9-26). 19.3±4.5 (13-27). NS. 18.2±4.0 (10-26). 16.8÷3.7 (10-25). NS. sex-appeal-consciousness. 8.8±3.2(3-15). 9.1±2.5 (4-13). NS. 8.9±3.1 (4-14). 9.6±3.3 (4-15). NS. Multidimensional Sexuality Questionnaire (mean, SD, range) internal-sexual-control. 17.7±3.3 (10-25). 18.6±3.6 (10-25). NS. 16.8±3.8 (9-22). 18.3±3.5 (12-25). NS. sexual-motivation. 17.4±3.9 (10-25). 18.4±3.3 (13-25). NS. 16.4÷4.7 (9-24). 17.2÷4.9 (6-25). NS. sexual-assertiveness. 10.9÷4.1(5-22). 9.6±4.4 (5-19). NS. 10.9÷4.3 (5-20). 10.1÷3.8 (5-18). NS. external-sexual-control. 11.2±39 (5-23). 9.3÷3.6 (5-16). NS. 11.6±4.7 (5-20). 10.0÷3.9 (5-19). NS. fear-of-sex. 13.2÷2.4 (8-18). 12.7÷2.0 (10-16). NS. 13.6÷2.5 (8-18). 13.8÷3.3 (5-21). NS. sexual-satisfaction. 17.0±4.5 (7-15). 18.3÷4.1 (11-23). NS. 16.7±4.9 (8-24). 17.8±4.8 (5-24). NS. Multidimensional Sexual Self-Concept Questionnaire (mean, SD, range). . 16.8±4.0 (7-25). 18.3±4.1 (11-25). NS. 17.1±4.6 (9-25). 18.3±3.8 (9-25). NS. motivation to avoid risky sex. 19.9±3.3 (13-25). 21.4±4.2 (1- 25). NS. 19.5±5.1 (8-25). 20.9±4.2 (9-25). NS. sexual-optimism. 19.2±3.1 (12-26). 19.6±3.2 (14-23). NS. 19.3±3.7 (11-24). 19.3±2.9 (14-25). NS. sexual problem self-blame. 13.7±3.3 (8-21). 14.5±3.0 (9 -19). NS. 13.0±3.6 (7-19). 13.7±3.1 (7-18). NS. sexual problem management. 15.2±2.9 (8-22). 15.9±3.3 (10-22). NS. 15.5±3.8 (7-22). 16.3±4.2 (5-24). NS. power-other sexual control. 10.8±3.1 (5-21). 9.4±4.1 (5-20). NS. 9.9±4.3 (5-22). 9.3±4.3 (5-23). NS. sexual self-schemata. 16.8±4.0 (7-25). 18.3±4.5 (11-25). NS. 17.2±5.2 (8-25). 17.1±3.7 (11-25). NS. sexual problem prevention. 16.4÷3.2(9-22). 17.1±2.6 (13-21). NS. 16.5±4.0 (9-21). 18.2±3.1 (11-24). NS. 2. * ch test/Fisher’s exact test for the qualitative variables; Mann-Whitney U test for the quantitative variables; SFK/K – the Mell-Krat Scale; SD – standard deviation. D *L
(473) %
(474) . % (67 '
(475) , !0-
(476) @@1) 8 ,( ! %O4? ! ( ' K#? ( &
(477)
(478) (*L
(479)
(480) (!((67!( !% ('
(481) ( %
(482) '' ,'( &
(483) ,
(484) %! %K4?) D (
(485) (DL %
(486) % (67 '
(487) , !0-
(488) @@1)8 ,9<U 67 % !'K4? 'K<# ( &
(489) %,
(490) % '4<U
(491) ) D (
(492) (D6L %
(493) % ( 67 '
(494) , ! 0-
(495) @@1) 8 , ( ! ! O4? ( ! %. (( '
(496) ( , ! C%, ,' &/
(497) ( D6L ' (!( ( , ! C ( &
(498)
(499) /
(500) (!( 67 ( !% ('
(501) ). 104. Discussion -(% 67%
(502) (
(503) ( ' &
(504) . % (' )*,
(505)
(506) ' ( , ( V !
(507) ( !C%' /C / 67 &
(508) 245)7 !( ( &
(509) %
(510) &( % (!(
(511) ' %
(512) &
(513) (
(514)
(515)
(516) )7 '% ,' %
(517)
(518) % (
(519) '!(
(520) ( 67 ' &
(521) ) D ! = &
(522) <)>T)< ' >) T) 67 !' O4? ' K4? ( ( ((='!
(523) ' 295)* %
(524) ! ! '@' ( ' &
(525)
(526) '0>) %1 '" ( % ( ( #?U ( % ' ! = : '> 2:<5)
(527)
(528) != ' ( &
(529) , %' ' % (67 '
(530) ( !!O4?)8 ,( ' ( ! % ! !!
(531) , !
(532) . © Polskie Towarzystwo Ginekologiczne. Nr 2/2015.
(533) Ginekol Pol. 2015, 86, 100-106. P R A C E. O R Y G I N A L N E g i n e kol og i a. Robert Kowalczyk et al. Sexuality in women with polycystic ovary syndrome.. 0@1) (@ + (( ( &
(534) , ( ' ( &
(535) ' 'E'
(536) )2>4?5(
(537) !! ( 67 SHUVH(
(538)
(539) % &
(540) ) -(
(541) ' ( '( (
(542) &
(543) , ,% ' %
(544) % (67 '((
(545) ( )@ ''( != ' ( ! (! '(% &
(546) &
(547) ,) J
(548) (
(549) ) ' 8 (
(550) )' %
(551) , 2>?5)8 ,% ( &
(552)
(553) (
(554)
(555) !=
(556) (!( % ( 67 !' K4? (
(557) )
(558)
(559)
(560) )'( (!( &
(561) ' ( ' ( &'
(562) &
(563) ,2>?5) -(
(564) !! ( % ( 67 (!(
(565) %, ' ' &
(566) , '
(567) % (' )-(
(568)
(569) ' ((!( ( &
(570) ,
(571) ( *LG % ( 67 ' K4? ! ' K#? % +
(572) (
(573) ' !( (
(574) '
(575) (& '( '' &
(576) )$(% 9<U 67 % !'K4? 'K<# ( &
(577) %,
(578) ( DL ( ( =% , , )@(
(579) ' (
(580) (( ( % (67 'K4? ! %, ' ' &
(581) ' ' &
(582)
(583) =
(584)
(585) % % (
(586)
(587) &
(588) ) @ ( ! ! O4? ( ! % ( ( '
(589) ( , ! (C%, ,' &/
(590) ( D6L ' (!( ( C ( &
(591)
(592) /
(593) (!( %!67 % ' !% ('
(594) )*''
(595)
(596) % ( &
(597) '
(598) (!((67! ' ! ! '! &
(599) '
(600)
(601) =' ' &2>?5) ( ' 'E
(602) ) 245 ( ' ( &
(603) ( , '. ( (
(604) !
(605) (!(
(606) ,
(607) & '' . ( ( +
(608) (672>4 495)-( ! % (67
(609)
(610) !! ! &
(611) ( , (
(612)
(613) &
(614)
(615) ,( , &
(616) , '& (!( '67
(617) '' % ) -( % &
(618) ( $ A
(619) '' ,
(620)
(621)
(622) != ' % ( 67 ' (
(623) (
(624) ( (
(625) ,
(626) ' &
(627) ' ( + &
(628) ,) %
(629)
(630) ( ,', ' )@ ( = ' 67 (
(631) ) % '#? % ( 67 '#?(
(632) (
(633) ' '' &
(634) 295) J
(635) (
(636) ) ,' ( + &
(637) &
(638) (!( ' '! ( %( ( ' %
(639) % (67 '(
(640) (
(641) 2?5)%
(642)
(643) 8 (
(644) ) ' &
(645) ? % (67 ' '' ( + &
(646) 2>5) -( ,
(647) &
(648) ' %! % ( 67, #U '4>U2<5)@ '
(649) (!( (,
(650) &
(651) ' '%'
(652)
(653) != ' ' ' 67. % '(
(654) (
(655) , ( !! ( (% ($ A
(656) ) Nr 2/2015. -( ! %! !! % & &
(657) , (!( % ( 67 (
(658) ( '
(659)
(660) != )@( ! &
(661) % (67*! ,
(662)
(663) )
(664) '' ( 67 % +
(665) %!
(666) ( ( &
(667) %24:5)8 ,(='! ( ,
(668) ' ' =%' ') -( V
(669) ,
(670) &
(671) . % ( 67
(672) ) *
(673) (!(
(674) !
(675) '
(676) !'
(677) ' ' 8 (
(678) ) '' '
(679) ' &
(680) 24<5( ( '' ='! )-(
(681) ',
(682)
(683) ) ( ' &
(684) > % (67 !(6( ! &
(685) $ ! L 06$L1 ' ) -( (
(686) '
(687) ,
(688) ( 6$L
(689) ' ' ( % ( 67 ' (
(690)
(691) %
(692) ,
(693) '( ,(
(694) &
(695) . ( ( ((!(
(696) ,
(697) ( '! ' )$(% (
(698) ! ' ( '!% ,
(699) ' ( &
(700) ! (
(701) ' ( % (
(702) ( 6$L) 8 ,
(703) , ' %
(704) ,
(705) %. (67 ' ( ' (
(706)
(707)
(708) ,
(709) ' (!( ' ',
(710) ' ( (%
(711) ' (!
(712) (
(713) (( ! ,
(714) V ! &
(715) )*
(716) !(
(717) '
(718) ' 67 % ( %
(719) % ! ( ! ' &
(720) ' 245)@ ' 6!
(721) '6'
(722) &
(723) '
(724) ,
(725) ( %. (( '67 '' '!( ' ' ! ,
(726) (
(727) (
(728) % ' 2:5) %
(729)
(730) I
(731) ) ''%' !! '
(732) '% &! ' ' ' ' 24> ?5)8 , (
(733) ''( &! %!( '
(734) %'! ( '!% )@ (
(735) (!(
(736) ,
(737) ( '! %!( V &
(738) '
(739) % ! ( (
(740) ' ( % ' )-( %!( !! , ' % % (67) *
(741) (!( ''' (
(742) ,
(743) %
(744)
(745) %% ( '! %
(746)
(747) ,
(748) ')-(
(749) ( '( % (67( '(!( ($% I
(750)
(751)
(752) (
(753) ( ' 'ED@)-(
(754) ( ! ( (
(755)
(756)
(757) ' & , '( 0 1 ' (
(758) !
(759)
(760) % 67 ( ,
(761) ' '8 (
(762) )25); '
(763)
(764) ) & %' ?? % ( 67 '
(765) '' ( ( % ' ( ' ' +
(766)
(767) ' %
(768) &
(769) % '(@'& &
(770) 2<5)J
(771) (
(772) )'( 67 %
(773) ( ( !=
(774)
(775) =' (( &
(776) ' '(% !=
(777)
(778) &
(779)
(780) ,)*
(781) '
(782) ,'( & ,'( ! ,
(783) ' ( &
(784) '
(785) %
(786) 2?5)%
(787)
(788) ,
(789)
(790)
(791) ) ,' (!( ! % ( ( '67 ' '
(792) ( &
(793) ' (! %
(794) (6$L245) *
(795) (!(( &
(796) % (67 '. %
(797) ( (
(798) (
Powiązane dokumenty
Celem niniejszej pracy jest ocena dobowego pro- filu ciśnienia skurczowego (SBP — systolic blood pressure) i rozkurczowego (DBP — diastolic blood pressure) oraz częstotliwości
Profil zaburzeń przemiany materii kobiet z PCOS jest bardzo podobny do tych stwierdzanych w zespole metabolicznym (MS). Kluczowym czynni- kiem sprawczym w obu tych zespołach
One study showed a negative correlation between adropin and fasting insulin levels, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), total cholesterol,
According to this explanation, TRAb and TPOAb antibody titres correlated with domain scores for erectile function, orgasmic function, and desire, but not with domain scores
On the basis of the obtained results, it seems that concomitant presence of both IFG and IGT is associated with a greater risk of sexual dysfunction and of depressive
Introduction: The aim of this study was to estimate serum fetuin-A levels in lean and obese women with polycystic ovary syndrome (PCOS) and to find possible relationships
In the sisters of the PCOS patients, we observed sig- nificantly higher levels of total testosterone and DHEA-S than in the women of the control group.. In eight of the 44
Prace na temat przebiegu menopauzy u kobiet z zespo³em policystycznych jajników (Po- lycystic Ovary Syndrome – PCOS) s¹ bardzo nieliczne, pomimo doœæ czêstego wystêpowa- nia
