Changes in Sexual Functioning in Women and Men in the 5 Years After Bariatric Surgery

Abstract

IMPORTANCE Short-term improvements in sexual functioning are reported after bariatric surgery, but to our knowledge, little is known about the durability of these improvements. OBJECTIVE To determine the percentage of adults with impairment in sexual functioning who experience durable improvements in sexual functioning after bariatric surgery and to identify factors associated with improvements. DESIGN, SETTING, AND PARTICIPANTS The Longitudinal Assessment of Bariatric Surgery-2 is an observational cohort study conducted at 10 hospitals in 6 US clinical centers. Adults undergoing their first bariatric procedure were recruited from 2005 through 2009, data were collected through August 2014. Data analysis was conducted from 2016 to April 2018. INTERVENTIONS Participants completed assessments before the procedure and annually thereafter for 5 years. MAIN OUTCOMES AND MEASURES A self-administered questionnaire was used to assess clinically meaningful differences before and after surgery in past-month sexual satisfaction, desire, and activity and physical health limitations to sexual activity among subgroups who reported sexual functioning at less than domain-specific thresholds before surgery. RESULTS Of 2215 participants eligible for sexual function follow-up, 2036 (91.9%) completed 1 or more follow-up assessment (1431 [64.6%] at year 5), of whom 1607 (78.9%) were women. At the presurgery assessment, median (interquartile range) age was 47 (37-55) years, and the median (interquartile range) body mass index was 45.8 (41.7-51.3). Among those who were not satisfied with their sexual life before surgery (1015 of 1456 women [69.7%]; 304 of 409 men [74.3%]), 56.0% of women (95% CI, 52.5%-59.5%) and 49.2% of men (95% CI, 42.4%-55.9%) experienced clinically meaningful improvements at year 1; these percentages did not significantly differ during further follow-up. Among those who reported physical limitations to sexual activity at baseline (892 of 1490 women [59.9%] and 267 of 406 men [65.8%]), the percentage experiencing improvement in this domain decreased during follow-up, but 73.6% (95% CI, 69.3%-78.0%) of women and 67.6% (95% CI, 59.6%-75.6%) of men continued to report improvements at year 5. Greater postsurgical reduction in depressive symptoms was independently associated with improvement in 4 domains of sexual life among women (frequency of sexual desire: adjusted relative risk [aRR] per 5-point decrease in

A New Beginning: Young Women’s Experiences and Sexual Function 18 Months After Bariatric Surgery

“…Sexual function was significantly improved, in accordance with several previous studies on sexual functioning after bariatric surgery. 17 , 18 , 30 Improvements in sexual life after bariatric surgery have previously been linked to a decrease in BMI and also linked to decreased body image dissatisfaction. 31 In a study on women with polycystic ovary syndrome and normal, overweight, and obese BMI, there was a negative correlation between HADS-A and HADS-D and the FSFI total score, suggesting a link between body dissatisfaction, distorted self-perceived body image, sexual dysfunction, and depression.…”

“… 16 Female sexual dysfunction improves after bariatric surgery. 17 , 18 There is also some evidence that the incidence of pregnancies increases after bariatric surgery, but the mechanisms behind this effect remain unknown. 19 , 20 In a previous qualitative study, young childless women had high expectations on getting back to a normal life including better sexual health and improved fertility.…”

Changes in the sexual functions of male patients and their partners after obesity surgery

“…In a meta-analysis conducted by Coulman et al (2017), it was shown that bariatric surgery had positive effects on physical health, psychological health, sexual life and body image by leading to weight loss in individuals. In another study, approximately half the men and women that were not satisfied with their sexual lives before bariatric surgery experienced an improvement in satisfaction during the 5-year follow-up (Steffen et al, 2019). Unlike our study, the authors evaluated the sexual function of both genders, but not their partners.…”

Review: Sex-Specific Aspects in the Bariatric Treatment of Severely Obese Women

“…At this time, 73.6% (95% CI: 69.3%-78.0%) of the women who had physical limitations to sexual activity before bariatric surgery still reported an improvement. The improvement was independent of the type of surgical procedure [20].…”