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研究生:陳菁徽
研究生(外文):Ching-Hui Chen
論文名稱:多囊性卵巢症候群相關因子與性傾向相關性之探討
論文名稱(外文):The Investigation of the Correlation between Polycystic Ovary Syndrome (PCOS) Related Factors and Sexual Orientation
指導教授:朱元祥朱元祥引用關係
指導教授(外文):Yuan-Xiang Zhu
學位類別:博士
校院名稱:樹德科技大學
系所名稱:人類性學研究所
學門:其他學門
學類:其他不能歸類之各學類
論文種類:學術論文
論文出版年:2014
畢業學年度:103
語文別:英文
論文頁數:54
中文關鍵詞:異性戀同性戀多囊性卵巢症候群性傾向台灣
外文關鍵詞:heterosexuallesbianpolycystic ovary syndromesexual orientationTaiwan.
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多囊性卵巢症候群是一項常見的婦科疾病,常導致諸多荷爾蒙失調的症狀,尤其其引起之不孕症,影響了4-10%生育年齡的婦女。此症候群臨床上常呈現雄性激素血中濃度增高,排卵能力降低,寡經,身體和面部毛髮增生,青春痘,以及多囊性卵巢的情況。此外,也可能造成代謝性的荷爾蒙失調,與胰島素阻抗症。多囊性卵巢症候群之致病機轉至今仍未清楚,但觀察到此症候群常與不孕症,第二型糖尿病,心血管疾病,以及子宮內膜癌的發生有關。此外,也有一些研究表明,多囊性卵巢症候群的發生率可能因種族以及性傾向而不同。然而,此症候群的患病率與特定性傾向族群之關係,目前仍付之闕如。因此,在本研究中,我們嘗試探索性傾向以及多囊性卵巢症候群在臨床上相關之危險因子的關聯。
在本研究中,我們採取橫斷面研究方法,自台北醫學大學婦產科門診病患中招募受試者。總共有177例受試者參與了本研究。我們發現,在多囊性卵巢症候群的患者中,相較異性戀婦女族群,性傾向為女同性戀者顯著具有較高的身體質量指數(BMI= 22.5±5.2 v.s. 26.2±1.9; p=0.031),並且有較高的家族糖尿病史比例 (85.7% v.s. 64.4%)。這暗示了女同性戀族群可能是多囊性卵巢症候群相關的糖尿病之高危險性族群。
本研究探討多囊性卵巢症候群之相關因子與性傾向之關聯性,有助於了解多囊性卵巢症候群是否於女同性戀族群中有更高的發生率,以及其可能的原因。本研究成果將有助於臨床上針對女同性戀的多囊性卵巢症候群患者進行更有效的疾病預防與治療。

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder, affecting 4-10% of reproductive-aged women worldwide. The clinical diagnostic criteria for PCOS include androgen excess (either clinical or biochemical), anovulation, and polycystic ovaries (PCO) as observed by ultrasound. Hence, the clinical signs and symptoms of PCOS are related to hormonal imbalances, lack of ovulation and insulin resistance, leading to consequences of: irregular or absent menstrual periods, excessive growth of body and facial hair, adult acne, PCO, metabolic syndrome, and endometrial cancer. The exact cause of PCOS is unclear; it is considered a complex genetic disease that is often associated with infertility, type II diabetes, cardiovascular disease, and endometrial cancer. There are a few studies that have indicated that the prevalence and features of PCOS may vary by race and sexual orientation. However, studies on the connection between the prevalence of polycystic ovary syndrome and sexual orientation have been the subject of relatively little health research. In this study, we aim to explore the association between sexual orientation and PCOS-related parameters.
A cross-sectional study method with participants recruited from the regular outpatient clinic at the department of Obstetrics and Gynecology at Taipei Medical University Hospital was carried out. A total of 177 patients participated in the study. We found that patients with PCOS who identified themselves as lesbians (with regard to sexual orientation) tended to possess higher body mass index (26.2±1.9 v.s. 22.5±5.2; p=0.031) and higher rate of DM family background (85.7% v.s. 64.4%) than the women in the study with PCOS that identified themselves as heterosexuals. Our data indicated that high BMI was associated with sexual orientation (as evidenced by the results of lesbian PCO women in Taiwan), and may cause women who identify themselves as lesbians to be more vulnerable to PCOS-related DM. As health risks related to hormonal imbalances may be underestimated in the homosexual population due to cultural factors, the results could help to identify a potential high risk population to PCOS, and contribute to women’s health care in the future.

CONTENTS

1.INTRODUCTION...........................................1
1.1. The profile of a female menstrual cycle ………………………...1
1.2. An overview of polycystic ovary syndrome ………….......5
1.3. The definition of polycystic ovary syndrome ….………………7
1.4. The clinical presentation of polycystic ovary syndrome ……….. 8
1.5. The associated risks of polycystic ovary syndrome.……….........12
1.6. The treatment options for polycystic ovary syndrome ….............15
1.7. Sexual function, sexual orientation, and polycystic ovary syndrome.......................................16

2. OBJECTIVE AND SIGNIFICANCE………………………………19

3. MATERIALS AND METHODS…………………………………..20
3.1. Study design……………………………………………………20
3.2. Data collection………………………………………………….21
3.3. Measurement and observation……….....21

4. RESULTS…………………………………………………………….23
4.1. The clinical characteristics of polycystic ovary syndrome in those of different sexual orientations as compared with the controls……….23
4.2. Polycystic ovary syndromeis associated with higher serum levels of testosterone…………………………………...…………………26
4.3. High rate of family history of diabetes mellitus in lesbian polycystic ovary syndrome patients……………………………29

5. DISCUSSION……………..…………………………………………33
5.1. A higher incidence of polycystic ovary syndrome in the lesbian population in Taiwan..........................33
5.2. Androgen related factors are not significantly different in Taiwanese women of different sexual orientations, with or without polycystic ovary syndrome………...……………….………………...34
5.3. Lesbians may be more vulnerable to PCOS-related DM than heterosexual women due to high BMI and insulin resistance………...36
5.4. Psychosocial factors involved in lesbian population with high BMI………………………………………………………………38

6. CONCLUSION..……………..……………………………………….40

7. REFERENCES…………………………………..……………...……41

8. APPENDIX………………………………..…………………...…….50

LIST OF FIGURES AND TABLES
FIGURES:
Figure 1: Female menstrual cycle ………………………………………....3
Figure 2: Abnormal circulation ratio of LH to FSH in women with polycystic ovary syndrome ……………………..……………....4
Figure 3: PCOS changes women’s health paradigm from youth to old age……………………………………………………...……....6
Figure 4: Metabolic and reproductive factors in PCOS phenotype……………………………………………………....15
Figure 5: Comparison of BMI between heterosexual, lesbian and non- PCOS group………………..…………………………………..25
Figure 6: Serum concentrations of total testosterone and androstenedione in women with polycystic ovary syndrome of different sexual orientations (heterosexuals and lesbians), compared with women without polycystic ovary syndrome (Non-PCOS)…………………………………………….....….27
Figure 7: Serum concentrations of sex-hormone binding globulin (SHBG) and free androgen index (FAI) in women with polycystic ovary syndrome of different sexual orientations (heterosexuals and lesbians)……………….…………………………………...….31
Figure 8: Family history of DM in PCOS patients of different sexual orientations……………….………………………….……...….32
TABLES:
Table 1: The clinical and biochemical baseline characteristics of PCOS in different groups based on sexual orientation……………………24

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