Gebelerde cinsel fonksiyon değerlendirmesi: Serum androjen ve fetal cinsiyet ilişkisi

Yıl 2019, Cilt: 50 Sayı: 2, 64 - 69, 15.06.2019

Bahar Sarıibrahim Astepe

https://doi.org/10.16948/zktipb.533351

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

Öz

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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