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01-08-2021 | Obesity | Original Contributions

Influence of Gastric Bypass on Obese Women Sexual Function—a Prospective Study

Authors: Mariano de Almeida Menezes, Fernando Augusto Mardiros Herbella, Guilherme de Godoy dos Santos, Antônio Carlos Valezi

Published in: Obesity Surgery | Issue 8/2021

Abstract

Introduction

Obesity may lead to hyperandrogenia and affect female sexual function. The study aims to evaluate female sexual function and androgenic profile in obese women after laparoscopic Roux-en-Y gastric bypass (LRYGB).

Methods

Forty obese women with a mean age of 34 years were prospectively studied. Diabetes and psychiatric and pelvic disorders were the exclusion criteria. All patients underwent LRYGB. Total (TT) and free (FT) testosterone, androstenedione (AD), dehydroepiandrosterone (DHEA) and the Sexual Quotient - Female Version were evaluated, preoperatively, 6 and 12 months after the operation.

Results

Preoperative incidence of sexual dysfunction was 10% and hyperandrogenia was 40%. At 6 months, sexual function was not different; and FT (0.49–0.33 ng/dl) and AD (2.0–1.3 ng/dl) decreased significantly. At 12 months, there was an improvement in female sexual function (77–84 points), related to desire and interest (22–25 points) and comfort (15.9–17.3 points) without case of sexual dysfunction at 12 months. Hyperandrogenia (40–8%), FT levels (0.5–0.3 ng/dl), and AD (2.0–1.4 ng/dl) decreased, while DHEA levels (3.4–4.2 ng/dl) increased. The percentage of weight loss was 22% and 31% at 6 and 12 months, respectively. Sexual function did not correlate with BMI, weight, or androgen levels in any period.

Conclusion

Female sexual function in obese women with no diabetes and psychiatric and pelvic disorders improved in patients undergoing LRYGB, especially in desire, interest, and sexual comfort, and this occured after 6 months of the operation and unrelated to BMI, percentage of weight loss, or androgen levels.

Key Points

• In obese women with no diabetes and psychiatric and pelvic disorders the FSD improvement after LRYGB.

• FSD no correlation with weight loss and BMI.

• FSD no correlation with androgens levels.

Jäger P, Wolicki A, Spohnholz J, et al. Review: sex-specific aspects in the bariatric treatment of severely obese women. Int J Environ Res Public Health. 2020;17(8):2734. https://doi.org/10.3390/ijerphl17082734.CrossRefPubMedCentral

Obeid NR, Dimick JB, Telem DA. Sexual function after bariatric surgery: a new level of comorbidity improvement. Jama Surg. 2019;154(6):499. https://doi.org/10.1001/jamasurg.2018.1163.CrossRefPubMed

Derogatis LR, Sand M, Balon R, et al. Toward a more evidence-based nosology and nomenclature for female sexual dysfunctions-part I. J Sex Med. 2016;13(12):1881–7. https://doi.org/10.1016/j.jsxm.2016.09.014.CrossRefPubMed

Sarwer DB, Spitzer JC, Wadden TA, et al. Sexual functioning and sex hormones in persons with extreme obesity and seeking surgical and non-surgical weight loss. Surg Obes Relat Dis. 2013;9(6):997–1007. https://doi.org/10.1016/j.soard.2013.07.003.CrossRefPubMed

Gao Z, Liang Y, Deng W, et al. Impact of bariatric surgery on female sexual function in obese patients: a meta-analysis. Obes Surg. 2020;30(1):352–64. https://doi.org/10.1007/s11695-019-04240-5.CrossRefPubMed

Gandhi J, Dagur G, Warren K, et al. The role of diabetes mellitus in sexual and reproductive health: an overview of pathogenesis, evaluation, and management. Curr Diabetes Rev. 2017;13(6):573–81. https://doi.org/10.2174/1573399813666161122124017.CrossRefPubMed

Castelo-Branco C, Naumova I. Quality of life and sexual function in women with polycystic ovary syndrome: a comprehensive review. Gynecol Endocrinol. 2020;36(2):96–103. https://doi.org/10.1080/09513590.2019.1670788.CrossRefPubMed

Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol. 2018;14:270–84. https://doi.org/10.1038/nrendo.2018.24.CrossRefPubMed

Valderhaug TG, Hertel JK, Nordstrand N, et al. The association between hyperandrogenemia and the metabolic syndrome in morbidly obese women. Diabetol Metab Syndr. 2015;7:46. https://doi.org/10.1186/s13098-015-0040-5.CrossRefPubMedPubMedCentral

10.

Kolotkin RL, Zunker C, Ostbye T. Sexual functioning and obesity: a review. Obesity (Silver Spring). 2012;20(12):2325–33. https://doi.org/10.1038/oby.2012.104.CrossRef

11.

Valezi AC, Menezes MA, Mali Jr J. Weight loss outcome after Roux-en-Y gastric bypass: 10 years of follow-up. Obes Surg. 2013;23(8):1290–3. https://doi.org/10.1007/s11695-013-0908-0.CrossRefPubMed

12.

Steffen KJ, King WC, White GE, et al. Changes in sexual functioning in women and men in the 5 years after bariatric surgery. JAMA Surg. 2019;154(6):487–98. https://doi.org/10.1001/jamasurg.2018.1162.CrossRefPubMedPubMedCentral

13.

Li YJ, Han Y, He B. Effects of bariatric surgery on obese polycystic ovary syndrome: a systematic review and meta-analysis. Surg Obes Relat Dis. 2019;15(6):942–50. https://doi.org/10.1016/j.soard.2019.03.032.CrossRefPubMed

14.

Resolução do Conselho Federal de Medicina n° 2.131 de 2015. http://www.portalmedico.org.br/resolucoes/CFM/2015/2131_2015.pdf.

15.

Ramos AC, Silva AC, Ramos MG, et al. Simplified gastric bypass: 13 years of experience and 12,000 patients operated. Arq Bras Cir Dig. 2014;27(Suppl1):2–8.CrossRef

16.

Abdo CHN. Quociente sexual feminino: um questionário brasileiro para avaliar a atividade sexual da mulher. Diagn Tratamento. 2009;14(2):89–91.

17.

Lima SMRR, Silva HFS, Postigo S, et al. Disfunções sexuais femininas: questionários utilizados para avaliação inicial. Arq Med Hosp Fac Med Santa Casa São Paulo. 2010;55(1):1–6.

18.

Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for estimation of free testosterone in serum. J Clin Endocrinol Metabol. 1999;84(10):3666–72. https://doi.org/10.1210/jcem.84.10.6079.CrossRef

19.

Escobar-Morreale HF, Botella-Carretero JI, Álvares-Blasco F, et al. The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2005;90(12):6364–9. https://doi.org/10.1210/jc.2005-1490.CrossRefPubMed

20.

Nestler JE. Metformin for the treatment of the polycystic ovary syndrome. N Engl J Med. 2008;358(1):47–54. https://doi.org/10.1056/NEJMct0707092.CrossRefPubMed

21.

Davis SR, Worsley R, Miller KK, et al. Androgens and female sexual function and dysfunction – findings from the Fourth International Consultation of Sexual Medicine. J Sex Med. 2016;13(2):168–78. https://doi.org/10.1016/j.jsxm.2015.12.033.CrossRefPubMed

22.

Cherick F, Te V, Anty R, et al. Bariatric surgery significantly improves the quality of sexual life and self-esteem in morbidly obese women. Obes Surg. 2019;29(2):1576–82. https://doi.org/10.1007/s11695-019-03733-7.CrossRefPubMed

23.

Paul R, Andersson E, Wirén M, et al. Health-related quality of life, sexuality and hormone status after laparoscopic Roux-en-y gastric bypass in women. Obes Surg. 2020;30(2):493–500. https://doi.org/10.1007/s11695-019-04197-5.CrossRefPubMed

24.

Sarwer DB, Wadden TA, Spitzer JC, et al. Four year changes in sex hormones, sexual functioning, and psychosocial status in women who underwent bariatric surgery. Obes Surg. 2018;28(4):892–9. https://doi.org/10.1007/s11695-17-3025-7.CrossRefPubMedPubMedCentral

25.

Oliveira CFA, Dos Santos PO, de Oliveira RA, et al. Changes in sexual function and positions in women with severe obesity after bariatric surgery. Sex Med. 2019;7(1):80–5. https://doi.org/10.1016/j.esxm.2018.10.001.CrossRefPubMed

Title: Influence of Gastric Bypass on Obese Women Sexual Function—a Prospective Study
Authors: Mariano de Almeida Menezes
Fernando Augusto Mardiros Herbella
Guilherme de Godoy dos Santos
Antônio Carlos Valezi
Publication date: 01-08-2021
Publisher: Springer US
Keywords: Obesity
Obesity
Bariatric Surgery
Bariatric Surgery
Polycystic Ovary Syndrome
Polycystic Ovary Syndrome
Androgens
Testosterone
Published in: Obesity Surgery / Issue 8/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-021-05509-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Influence of Gastric Bypass on Obese Women Sexual Function—a Prospective Study

Abstract

Introduction

Methods

Results

Conclusion

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Key Points

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