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Surgery and sexual health

Bariatric surgery improves sexual life experience after five years

The type of surgical procedure was not associated with improvement

Approximately half of women and men who reported pre-surgical dissatisfaction with sexual life experienced post-surgical improvements in satisfaction five years after bariatric surgery, according to researchers in the school of pharmacy at North Dakota State University, Fargo. In addition, a large percentage of patients experienced improvements in the frequency of sexual desire and activity and in physical limitations to sexual activity. Nevertheless, the percentage of participants with improvements in the frequency of sexual desire and activity decreased between one and five years.

The study, ‘Changes in Sexual Functioning in Women and Men in the 5 Years After Bariatric Surgery’, published in JAMA Surgery, sought 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.

Using data from The Longitudinal Assessment of Bariatric Surgery-2 (LABS2) study, conducted at ten hospitals in six US clinical centres, the study included 2,215 participants eligible for sexual function follow-up; 2,036 (91.9%) completed one or more follow-up assessment 1,431 (64.6%) at year five, of whom 1,607 (78.9%) were women.

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.

At the pre-surgery assessment, median (interquartile range) age was 47 (37-55) years, and the median (interquartile range) body mass index 45.8 (41.7-51.3). Among those who were not satisfied with their sexual life before surgery (1,015 of 1,456 women, 69.7%); 304 of 409 men (74.3%), 56.0% of women and 49.2% of men experienced clinically meaningful improvements in the first year; these percentages did not significantly differ during further follow-up. Among those who reported physical limitations to sexual activity at baseline (892 of 1,490 women, 59.9% and 267 of 406 men, 65.8%), the percentage experiencing improvement in this domain decreased during follow-up, but 73.6% of women and 67.6% of men continued to report improvements in the fifth year.

Greater postsurgical reduction in depressive symptoms was independently associated with improvement in four domains of sexual life among women (frequency of sexual desire p<0.001; frequency of sexual activity p<0.001; the degree to which physical health limited sexual activity p<0.001; and satisfaction with sexual life p<0.001) and two domains among men (physical health limitations p=0.008 and satisfaction with sexual life p<0.001). The type of surgical procedure was not associated with improvement.

In females, fewer pre-surgical depressive symptoms and a postsurgical decrease in depressive symptoms were independently associated with higher chance of improvement in all 4 domains of sexual functioning in women. Greater weight loss was associated with a higher chance of improvement in three domains and younger age was associated with a higher chance of improvement in two domains.

In males, fewer pre-surgery depressive symptoms and a postsurgical decrease in depressive symptoms were associated with a higher chance of improvement in the degree physical health limits sexual activity and satisfaction with sexual life, and stopping antidepressant use was associated with a higher chance of improvement in three domains.

“Depressive symptoms and antidepressant medication were associated with sexual functioning among adults who underwent bariatric surgery. Thus, future research should further explore the association between depression symptoms, treatment for depression, and sexual functioning after bariatric surgery,” the authors concluded. “Clinicians should assess patient satisfaction with sexual functioning before and after bariatric surgery. They should also consider interventions targeted to modifiable factors that may influence the likelihood of improvement.”

To access this paper, please click here

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