Bariatric surgery and female sexuality: is there an improvement in sexual function after weight loss?

Main Article Content

Hosannah Leite-Filho
https://orcid.org/0009-0005-5203-9518
Daniel Vieira de Oliveira
https://orcid.org/0000-0002-6768-3286
Mariano Palermo
https://orcid.org/0000-0001-7366-3321
Rui josé da Silva Ribeiro
https://orcid.org/0000-0003-4150-2325
Paz Piatanesi
https://orcid.org/0009-0006-2894-5833
Paulo Afonso Nunes Nassif
https://orcid.org/0000-0002-1752-5837

Abstract

Introduction: Severe obesity is most effectively treated with bariatric surgery. The resulting weight loss is expected to improve obesity-related conditions, including sexual dysfunction.


Objective: To evaluate the sexual function of morbidly obese women undergoing bariatric surgery using a questionnaire validated at three time points: preoperatively, six months and twelve months later.


Method: A quantitative, descriptive and analytical cross-sectional, quasi-experimental study was carried out with a convenience sample of women over 18 years of age, with class III obesity, submitted to Roux-en-Y gastric bypass. The questionnaire adopted was the Female Sexual Function Index (FSFI), which evaluates six domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Scores above 26.55 translate satisfactory sexual function and lower scores define sexual dysfunction.


Results: A total of 74 women were evaluated from 36.2 ± 8.3 years, BMI before surgery was 42.7 ± 4.0, after six months 31.8 ± 3.5 and after 12 months 30.0 ± 3.6. The mean total FSFI score obtained in the preoperative period was 20.7. After six months, 27.7 (p < 0.01), and after 12 months, 29.4 (increase of 42.0% compared to the preoperative period). Both in terms of the total score and the isolated domains of the FSFI, an association was observed between improved sexual function and reduced BMI.


Conclusion: There was a significant improvement in sexual function as early as six months after surgery, as well as in the other domains alone. 

Article Details

Section

Original Article

References

Office of the Surgeon General (US); Office of Disease Prevention and Health Promotion (US); Centers for Disease Control and Prevention (US); National Institutes of Health (US). The Surgeon General's Call To Action To Prevent and Decrease Overweight and Obesity. Rockville (MD): Office of the Surgeon General (US); 2001. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK44206/

Mancini MC. Cirurgia bariátrica – Uma atualização para o endocrinologista. Arq Bras Endocrinol Metab. 2014;58(9):875-88. https://doi.org/10.1590/0004-2730000003413

Sarwer DB, Steffen KJ. Quality of Life, Body Image and Sexual Functioning in Bariatric Surgery Patients. Eur Eat Disord Rev. 2015;23(6):504-8. https://doi.org/10.1002/erv.2412

Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;2014(8):CD003641. https://doi.org/10.1002/14651858.cd003641.pub4

da Silva CF, Cohen L, Sarmento LA, Rosa FMM, Rosado EL, Carneiro JRI, et al. Effects of long-term roux-en-y gastric bypass on body weight and clinical metabolic comorbidities in bariatric surgery service of a university hospital. arq. bras. cir. Dig. 2016;29(Supl.1):20-3. https://doi.org/10.1590/0102-6720201600S10006

Andersen JR, Aasprang A, Karlsen TI, Natvig GK, Våge V, Kolotkin RL. Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies. Surg Obes Relat Dis. 2015;11(2):466-73. https://doi.org/10.1016/j.soard.2014.10.027

Sarwer DB, Crerand CE. Body image and cosmetic medical treatments. Body Image. 2004;1(1):99-111. https://doi.org/10.1016/s1740-1445(03)00003-2

Esposito K, Giugliano D. Obesity, the metabolic syndrome, and sexual dysfunction. Int J Impot Res. 2005;17(5):391-8. https://doi.org/10.1038/sj.ijir.3901333

Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191-208. https://doi.org/10.1080/009262300278597

Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005;31(1):1-20. https://doi.org/10.1080/00926230590475206

Larsen SH, Wagner G, Heitmann BL. Sexual function and obesity. Int J Obes (Lond). 2007;31(8):1189-98. https://doi.org/10.1038/sj.ijo.0803604

Esfahani SB, Pal S. Obesity, mental health, and sexual dysfunction: A critical review. Health Psychol Open. 2018;5(2):2055102918786867. https://doi.org/10.1177/2055102918786867

Kim KK, Kang HC, Kim SS, Youn BB. Influence of weight reduction by sibutramine on female sexual function. Int J Obes (Lond). 2006;30(5):758-63. https://doi.org/10.1038/sj.ijo.0803198

Kolotkin RL, Binks M, Crosby RD, Østbye T, Gress RE, Adams TD. Obesity and sexual quality of life. Obesity (Silver Spring). 2006;14(3):472-9. https://doi.org/10.1038/oby.2006.62

Goitein D, Zendel A, Segev L, Feigin A, Zippel D. Bariatric Surgery Improves Sexual Function in Obese Patients. Isr Med Assoc J. 2015;17(10):616-9.

Bond DS, Wing RR, Vithiananthan S, Sax HC, Roye GD, Ryder BA, et al. Significant resolution of female sexual dysfunction after bariatric surgery. Surg Obes Relat Dis. 2011;7(1):1-7. https://doi.org/10.1016/j.soard.2010.05.015

Efthymiou V, Hyphantis T, Karaivazoglou K, Gourzis P, Alexandrides TK, Kalfarentzos F, et al. The effect of bariatric surgery on patient HRQOL and sexual health during a 1-year postoperative period. Obes Surg. 2015;25(2):310-8. https://doi.org/10.1007/s11695-014-1384-x