性愛前先運動能減少抗憂鬱藥物在性方面的副作用


  【24drs.com】運動除了有益健康和改善心情,新研究顯示,對於使用抗憂鬱藥物的婦女,運動還可以重建受藥物副作用影響的性慾與性功能。
  
  德州大學的研究者發現,性行為之前進行短暫的中等強度心血管運動,與因使用抗憂鬱藥物而嚴重性功能不佳之婦女改善性慾有關,且顯著改善性功能。
  
  現任職於Kinsey研究院的Tierney Lorenz博士表示,這個研究結果可增加抗憂鬱藥物的有效利用。
  
  Lorenz博士表示,身為醫師,希望病患可以評估治療是否有用;抗憂鬱藥物是救命藥,但是,如果病患因為可能有性方面的副作用而害怕或者不規律服用,它們就會無效。
  
  這篇研究線上登載於11月1日憂鬱症與焦慮症期刊。
  
  以前的研究認為,運動可以改善沒服藥之憂鬱婦女的性功能,性刺激之前的運動可以增加健康婦女的性慾。
  
  此外,Lorenz博士等人之前進行的研究認為,運動對於服用抗憂鬱藥物之婦女的性慾心理生理測量有正面效果,她們在觀看一部色情片之前先跑跑步機。
  
  雖然這些研究發現認為運動對那些經歷抗憂鬱藥物副作用的婦女有幫助,研究者設計此次研究,目的在自然條件中檢測這個假設。
  
  研究者寫道,實驗室中測量婦女的性慾心理生理可能無法代表性功能,女性生理慾望的客觀指標和女性主觀認定之間的關聯不大。
  
  在為期9週的研究中,52名婦女發生抗憂鬱藥物在性方面的副作用,要求她們每週進行3次性活動,定義是與伴侶進行或者自慰。
  
  3週的開始期之後,這些研究對象進行3週的治療期(進行運動),隨機指定每週在性活動之外的日子進行運動3次、或者在性活動前先運動;最後3週的研究期,這兩組互換。
  
  每一期結束時進行評估,採用多種認證方式測量性慾、性功能與滿意度,以及測量憂鬱和焦慮的情感,認知和生理症狀。
  
  研究對象配戴有時間標記的心律監測器,以確認有遵守運動處方的程度和時間,她們也需在線上日記記錄每次性活動與時間。
  
  此外,研究對象不知道「性活動前的運動有比較大的效果」這項研究假設,除了1名研究對象之外,其餘都表示他們認為這項研究只是運動對性生活的影響。
  
  研究者報告指出,定時運動對於性慾之測量,比開始時有統計上的顯著增加,非定時運動效果比較少,但是和定時運動沒有統計上的顯著差異。
  
  定時運動也與開始時性功能不佳婦女的整體性功能改善有關,但是藥物反應不太嚴重者的效果未達統計上的顯著程度。
  
  除了運動處方有關的治療效果,研究者也確認,藉由每週規律運動3次,性高潮也比開始時(試驗前平均每週運動1.37次)增加 。
  
  報告所指的性慾和功能的改善,與精神及生理健康的微小改變無關。
  
  研究者形容試驗前和運動組之間的改善是「適度但一致且和臨床有關的」。另外,他們指出,這是因為「沒有運動副作用的報告、病患接受度高、不會增加照護上的花費、以及有適度效果」。
  
  Lorenz博士指出,這些研究結果支持運動是可以減少抗憂鬱藥物在性方面之副作用的行為介入方法。
  
  她表示,直到最近,除了換藥或增加性方面的用藥之外,醫師們沒有太多方法處置這個副作用,「等副作用消失」的方法對多數人並沒有用。
  Lorenz博士期望自己未來在更多元的環境下檢測這個介入方式。她表示,重點在於觀察更常見的臨床狀況下,醫師無法如此密集監測病患過程下是否有相同發現。
  
  賓州醫學院精神科主任、未參與此次研究的Alan Gelenberg醫師受邀發表評論時表示,這是個有趣的模式,是篇好研究,臨床上值得嘗試。
  
  今年初發表於Journal of Nervous and Mental Disease這本期刊的文章中,Gelenberg醫師等人記錄了使用特定抗憂鬱藥物而新發生性功能不佳的高比率,對於抗憂鬱藥物反應最佳之患者的性方面副作用比率較低。
  
  資料來源: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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