性爱前先运动能减少抗忧郁药物在性方面的副作用


  【24drs.com】运动除了有益健康和改善心情,新研究显示,对于使用抗忧郁药物的妇女,运动还可以重建受药物副作用影响的性欲与性功能。
  
  德州大学的研究者发现,性行为之前进行短暂的中等强度心血管运动,与因使用抗忧郁药物而严重性功能不佳之妇女改善性欲有关,且显著改善性功能。
  
  现任职于Kinsey研究院的Tierney Lorenz博士表示,这个研究结果可增加抗忧郁药物的有效利用。
  
  Lorenz博士表示,身为医师,希望病患可以评估治疗是否有用;抗忧郁药物是救命药,但是,如果病患因为可能有性方面的副作用而害怕或者不规律服用,它们就会无效。
  
  这篇研究在线登载于11月1日忧郁症与焦虑症期刊。
  
  以前的研究认为,运动可以改善没服药之忧郁妇女的性功能,性刺激之前的运动可以增加健康妇女的性欲。
  
  此外,Lorenz博士等人之前进行的研究认为,运动对于服用抗忧郁药物之妇女的性欲心理生理测量有正面效果,她们在观看一部色情片之前先跑跑步机。
  
  虽然这些研究发现认为运动对那些经历抗忧郁药物副作用的妇女有帮助,研究者设计此次研究,目的在自然条件中检测这个假设。
  
  研究者写道,实验室中测量妇女的性欲心理生理可能无法代表性功能,女性生理欲望的客观指标和女性主观认定之间的关联不大。
  
  在为期9周的研究中,52名妇女发生抗忧郁药物在性方面的副作用,要求她们每周进行3次性活动,定义是与伴侣进行或者自慰。
  
  3周的开始期之后,这些研究对象进行3周的治疗期(进行运动),随机指定每周在性活动之外的日子进行运动3次、或者在性活动前先运动;最后3周的研究期,这两组互换。
  
  每一期结束时进行评估,采用多种认证方式测量性欲、性功能与满意度,以及测量忧郁和焦虑的情感,认知和生理症状。
  
  研究对象配戴有时间标记的心律监测器,以确认有遵守运动处方的程度和时间,她们也需在在线日记记录每次性活动与时间。
  
  此外,研究对象不知道「性活动前的运动有比较大的效果」这项研究假设,除了1名研究对象之外,其余都表示他们认为这项研究只是运动对性生活的影响。
  
  研究者报告指出,定时运动对于性欲之测量,比开始时有统计上的显著增加,非定时运动效果比较少,但是和定时运动没有统计上的显著差异。
  
  定时运动也与开始时性功能不佳妇女的整体性功能改善有关,但是药物反应不太严重者的效果未达统计上的显著程度。
  
  除了运动处方有关的治疗效果,研究者也确认,藉由每周规律运动3次,性高潮也比开始时(试验前平均每周运动1.37次)增加 。
  
  报告所指的性欲和功能的改善,与精神及生理健康的微小改变无关。
  
  研究者形容试验前和运动组之间的改善是「适度但一致且和临床有关的」。另外,他们指出,这是因为「没有运动副作用的报告、病患接受度高、不会增加照护上的花费、以及有适度效果」。
  
  Lorenz博士指出,这些研究结果支持运动是可以减少抗忧郁药物在性方面之副作用的行为介入方法。
  
  她表示,直到最近,除了换药或增加性方面的用药之外,医师们没有太多方法处置这个副作用,「等副作用消失」的方法对多数人并没有用。
  Lorenz博士期望自己未来在更多元的环境下检测这个介入方式。她表示,重点在于观察更常见的临床状况下,医师无法如此密集监测病患过程下是否有相同发现。
  
  宾州医学院精神科主任、未参与此次研究的Alan Gelenberg医师受邀发表评论时表示,这是个有趣的模式,是篇好研究,临床上值得尝试。
  
  今年初发表于Journal of Nervous and Mental Disease这本期刊的文章中,Gelenberg医师等人记录了使用特定抗忧郁药物而新发生性功能不佳的高比率,对于抗忧郁药物反应最佳之患者的性方面副作用比率较低。
  
  资料来源:http://www.24drs.com/professional/list/content.asp?x_idno=7033&x_classno=0&x_chkdelpoint=Y
  

Exercise Before Sex Cuts Antidepressants' Sexual Side Effects

By Kenneth Bender
Medscape Medical News

Exercise can benefit health and improve mood, and now new research shows that it has the potential to restore sexual desire and function in women adversely affected by sexual side effects related to antidepressant use.

Investigators at the University of Texas at Austin found that a brief, moderate strength and cardiovascular exercise regimen preceding sexual activity was associated with improvement in sexual desire and significantly improved sexual functioning in women with more severe sexual dysfunction related to antidepressants.

Tierney Lorenz, PhD, now at the Kinsey Institute in Bloomington, Indiana, told Medscape Medical News that the study findings could increase the effective utilization of antidepressant medication.

"As a clinician, I want patients to have access to treatments that work. Antidepressants work — they are lifesaving medication," Dr. Lorenz said, "but they don't work if patients are too scared to try them, or take them inconsistently, because of potential sexual side effects."

The study was published online November 1 in Depression and Anxiety.

Natural Setting

Previous studies suggested that exercise has the potential to improve sexual function in depressed women who are not taking medication and that exercise prior to presentation of sexual stimuli could increase sexual arousal in healthy women.

In addition, earlier research conducted by Dr. Lorenz and colleagues suggested that exercise has a positive effect on psychophysiologic measures of sexual arousal in women taking antidepressant medications who were assigned to run a treadmill prior to being shown a sexually explicit film.

Although these findings suggested that exercise may benefit women experiencing antidepressant sexual side effects, the researchers designed the current study to test this hypothesis in a natural setting.

"Laboratory-based psychophysiological measures of women’s sexual arousal may not map onto sexual function, and the link between objective measures of female genital arousal and women’s subjective ratings is modest," the investigators write.

In the 9-week study, 52 women experiencing antidepressant sexual side effects were assigned to engage in sexual activity, defined as "sex with a partner or masturbation," 3 times a week.

After a 3-week baseline period, participants were randomly assigned to a 3-week treatment interval with exercise either 3 times a week separate from, or immediately prior to, the sexual activity; these groups crossed to the other condition in the final 3-week study period.

Assessments were conducted at the end of each 3-week interval with multiple, validated measures of sexual desire, function, and satisfaction, as well as measures of affective, cognitive, and physical symptoms of depression and anxiety.

Participants were given heart rate monitors with time stamps to determine compliance with the level and timing of the exercise regimen, and they recorded each sexual event onto online diaries with time stamp.

In addition, participants were blinded to the hypothesis that exercise occurring immediately prior to sexual activity would have greater efficacy, with all but 1 participant indicating that they assumed that the study was only about the effects of exercise on sexuality.

Clinically Relevant Results

The investigators report a statistically significant increase from baseline in sexual desire measures with the timed exercise. Nontimed exercise appeared to be of less benefit, but not statistically significantly different from the timed exercise.

Timed exercise was also associated with improved measures of global sexual functioning in women with clinical levels of sexual dysfunction at baseline, but the effect was not statistically significant in those with less severe reaction to the medication.

Distinct from the treatment effects associated with the exercise regimen, the researchers also determined that orgasm function was increased from baseline by the regular scheduling of sexual activity ─ 3 times weekly in contrast to the pretrial reported average of 1.37 times weekly.

Reported improvements in sexual desire and functioning were independent of the modest changes measured in mental and physical health.

The researchers characterize the improvements between pretrial and the experimental exercise arm as "modest but consistent and clinically relevant."

In addition, they note that inasmuch as there "were no reported adverse effects of exercise, high patient acceptability, and no additional cost burden of care, even moderate efficacy is promising."

Dr. Lorenz noted that these findings support exercise as a behavioral intervention to reduce the burden of antidepressant sexual side effects.

"Until very recently, there hasn't been much that physicians can do to help manage side effects other than swapping medications or adding a sex-specific medication to the regimen. The 'wait it out' approach does not work for most people," she said.

Dr. Lorenz anticipates that she will next test the intervention in more diverse settings.

"It will be critical to see if the same findings hold in a more common clinical situation, in which physicians cannot monitor patient's progress so intensively," she said.

Worth Trying

Commenting on the findings for Medscape Medical News, Alan Gelenberg, MD, chairman, Department of Psychiatry, Penn State College of Medicine, who was not involved in the research, said that "it is an interesting model, good study, and worth trying clinically."

In a study published earlier this year in the Journal of Nervous and Mental Disease, Dr. Gelenberg and colleagues documented high rates of new-onset sexual dysfunction with selected antidepressants and found lower rates of sexual side effects among patients who best responded to the antidepressants.

The authors and Dr. Gelenberg report no relevant financial relationships.

Depress Anxiety. Published online November 1, 2013.

    
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