Sexual Dysfunction in Women With Migraine and Overweight/Obesity: Relative Frequency and Association With Migraine Severity.
Sexual Dysfunction in Women With Migraine and Overweight/Obesity: Relative Frequency and Association With Migraine Severity.
复制标题
作者：
Bond DS;Pavlović JM;Lipton RB;Graham Thomas J;Digre KB;Roth J;Rathier L;O'Leary KC;Evans EW;Wing RR
以前的研究表明，偏头痛可能与女性性功能障碍（FSD）有关，尽管这种关联可能因超重/肥胖而复杂化。为了解开偏头痛和肥胖与FSD的关系，我们检查了：1）患有偏头痛和肥胖的女性的FSD率与无偏头痛的肥胖女性的匹配样本;和2）偏头痛和超重/肥胖参与者的较大样本中偏头痛严重程度指数与FSD之间的关联，控制重要的混杂因素。偏头痛和肥胖女性寻求行为减肥治疗以减少头痛（n=37）和非偏头痛对照组（n=37）寻求通过减肥手术减肥，年龄（±5岁），体重指数（BMI; ±3 kg/m2）和过去一个月报告的性活动相匹配。两组都完成了女性性功能指数（FSFI），并使用经验证的FSFI总截止评分来定义FSD。在偏头痛和超重/肥胖的参与者（n=105）中，单独的逻辑回归模型评估了偏头痛发作频率，强度和持续时间与FSD几率的相关性，控制了年龄，BMI，抑郁和焦虑。平均而言，参与者和匹配的对照组患有重度肥胖症（BMI=42.4±3.8 kg/m2;范围=35-49.9），年龄为37.3±7.2岁（范围=22-50）。偏头痛参与者和对照组之间的FSD率没有差异（56.8% vs. 54.1%，p= 0.82）。在偏头痛和超重/肥胖的参与者中，（38.2±7.8岁; BMI=34.8±6.4 [范围=25-50 kg/m2]; 8.0±4.3个偏头痛日/月，最大疼痛强度=5.9±1.4（0-10量表）;平均发作持续时间=18.3±9.7小时），FSD与发作频率无关（p= 0.31）、疼痛强度（p= 0.92）或发作持续时间（p= 0.35），但与更严重的焦虑症状相关（p <0.017）。性功能障碍的发生率在伴有和不伴有偏头痛的严重肥胖女性中没有差异。此外，偏头痛严重程度指数与超重/肥胖女性FSD风险增加无关。在更广泛的偏头痛女性人群中，以及正常体重和超重/肥胖状态的女性人群中复制本研究结果是必要的。
Previous studies suggest that migraine might be associated with female sexual dysfunction (FSD), although this association may be complicated by overweight/obesity. To disentangle relationships of migraine and obesity with FSD, we examined: 1) FSD rates in women who had migraine and obesity with a matched sample of women with obesity who were free of migraine; and 2) associations between indices of migraine severity and FSD in a larger sample of participants with migraine and overweight/obesity, controlling for important confounders. Women with migraine and obesity seeking behavioral weight loss treatment to decrease headaches (n=37) and non-migraine controls (n=37) with obesity seeking weight loss via bariatric surgery were matched on age (±5 years), body mass index (BMI; ±3 kg/m2), and reported sexual activity during the past month. Both groups completed the Female Sexual Function Index (FSFI), with a validated FSFI-total cutoff score used to define FSD. In participants with migraine and overweight/obesity (n=105), separate logistic regression models evaluated associations of migraine attack frequency, intensity, and duration with odds of having FSD, controlling for age, BMI, depression, and anxiety. On average, participants and matched controls had severe obesity (BMI=42.4±3.8 kg/m2; range=35–49.9) and were 37.3±7.2 years of age (range=22–50). FSD rate did not differ between migraine participants and controls (56.8% vs. 54.1%, p=.82). In the larger sample of participants with migraine and overweight/obesity (38.2±7.8 years of age; BMI=34.8±6.4 [range=25–50 kg/m2]; 8.0±4.3 migraine days/month, maximum pain intensity=5.9±1.4 on 0–10 scale; average attack duration=18.3±9.7 hours), FSD was not associated with attack frequency (p=.31), pain intensity (p=.92), or attack duration (p=.35), but was associated with more severe anxiety symptoms (ps<.017). Rates of sexual dysfunction did not differ in severely obese women with and without migraine. Moreover, indices of migraine severity were not associated with increased risk of FSD in women with overweight/obesity. Replication of present findings in wider populations of women with migraine and of both normal-weight and overweight/obese status are warranted.