LAS VEGAS — Sexual function improved in almost 70% of obese women who underwent bariatric surgery, according to data from a small prospective cohort study.
Almost two-thirds of the patients met clinical criteria for female sexual dysfunction prior to surgery. Six months after the bariatric procedures, only one in five women fulfilled the criteria.
“Across the whole sample, significant postoperative improvement occurred in all domains of the sexual function index,” Dale Bond, PhD, of Miriam Hospital and Brown University in Providence, R.I., reported here at the American Society of Metabolic and Bariatric Surgery meeting.
- Explain to patients that this study showed that sexual function improved in obese women who underwent weight-loss surgery.
- The study involved a relatively small number of patients.
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
“Greater sexual function improvement was associated with younger age, being married, and worse preoperative sexual function. Postoperatively, patients’ sexual function scores were indistinguishable from those of normative controls.”
Obesity increases the risk of sexual dysfunction in women. Women who are candidates for bariatric surgery have a higher prevalence of sexual dysfunction compared with women in residential weight-loss programs and overweight controls (Obesity 2006; 14: 472-479). Bond and colleagues previously reported that 60% of female bariatric surgery candidates met criteria for sexual dysfunction, as determined by the Female Sexual Function Index (Surg Obes Relat Dis 2009; 5: 698-704).
Few studies have evaluated the effect of bariatric surgery on female sexual function. In particular, no studies had employed a validated survey instrument to compare sexual function in obese women before and after bariatric surgery, said Bond.
In an effort to better define the effects of bariatric surgery on women’s sexual function, investigators studied 54 female candidates for bariatric surgery. The study was limited to women who reported being in stable relationships and were sexually active. Participants completed the Female Sexual Function Index three or four months before surgery and six months afterward.
The mean score on the Female Sexual Function Index increased from 24.0 before surgery to 29.4 afterward (P<0.001).
The preoperative assessment showed the women had a mean age of 43, a mean body mass index of 45, and that about a third were postmenopausal. More than three-fourths of the women were married, and half had completed at least four years of college.
Comorbid conditions included depression in 48.1%, hypertension in 44.4%, anxiety disorder in 35.2%, and diabetes in 18.5%. Bond reported that 44% of the women were taking antidepressants, and almost a third were using antireflux medications.
The Female Sexual Function Index consists of six domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) and has a range of total scores of 2 to 36. A total score ≤26.55 is the threshold for sexual dysfunction.
Prior to surgery, 63% of the women had sexual dysfunction as reflected in their index scores. Six months after surgery the prevalence of sexual dysfunction had declined to 22.2% (P<0.001). Before surgery, 34 women met criteria for sexual dysfunction. At postsurgical follow-up, the condition had resolved in 23 (68%).
The mean score on the Female Sexual Function Index increased (improved) from 24.0 at baseline to 29.4 after surgery (P<0.001). Bond said the patients’ score in each domain of the index increased to levels comparable to those of a historical normative control group.
The type of surgical procedure did not influence the likelihood of improvement in sexual function. Moreover, improvement was similar in women taking antidepressants at baseline (which can adversely affect sexual function) and those who were not.
“I think we should start looking at sexual function and measuring it preoperatively,” said Bond. “The results suggest that we can say that even women with the worst sexual function before surgery can obtain this kind of improvement, irrespective of the type of surgery they have.”
By Charles Bankhead, Staff Writer, MedPage Today
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner