1. Obese women who underwent bariatric surgery reported significant improvement in sexual functioning at two years.
2. These women also had increased reproductive hormone levels and improved psychosocial status.
Evidence Rating Level: 1 (Excellent)
Study Rundown: While bariatric surgery is performed with the goal of improving medical outcomes, several studies have shown that significant weight loss also improves many aspects of quality of life. This study demonstrated that in addition to losing weight after bariatric surgery, obese women also showed improvement in mental domains of quality of life and report significant improvements in sexual functioning that persisted at two years after surgery. The study is limited primarily by its patient selection of predominately white, well-educated women. While the benefits described are unlikely to be indications for bariatric surgery in the future, they are important considerations for the reproductive health of women undergoing bariatric surgery. It remains to be seen whether the improvements in sexual functioning persist at longer times post-surgery.
Relevant Reading: Sex hormones and bariatric surgery in men
In-Depth [prospective cohort study]: A total of 106 consecutive women from the Longitudinal Assessment of Bariatric Surgery study (average body mass index of 44.5) who reported involvement in a relationship of at least 12 months were recruited. 85 women underwent a Roux-en-Y bypass, and 21 got adjustable lap banding. Subjects were assessed using the Female Sexual Function Index (FSFI) and several additional health questionnaires, and had fasting blood labs drawn for several sex hormones. At two years, the women had lost a mean 33.5% (95% CI, 31.5-35.6%) of their body weight. Women reported significant improvement of their total FSFI score at one year, which was maintained at year two. Women who preoperatively reported the lowest sexual functioning scores experienced the greatest improvement. At year one, significant hormone improvement was seen with FSH, LH, SHBG, estradiol, and total testosterone. These improvements were maintained at year two, at which point changes in DHEA-S were also statistically significant.
By Mariya Samoylova and Chaz Carrier
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