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Surgery and female sexual function

Bariatric surgery and sexual function in women

Credit: Flickr/Queereaster
The study compared factors including weight loss, sexual experience (including sex drive, arousal, orgasm, and satisfaction), body image, depression and anxiety

Bariatric surgery alleviates anxiety and depression symptoms and improves body image and sexual function in female obese patients, according to a study ‘Changes in Sexual Functions of Female Patients After Bariatric Surgery: Relationship with Body Image, Depression, and Anxiety’, that assessed the prevalence of sexual dysfunction in women before and six months after bariatric surgery, published in Bariatric Surgical Practice and Patient Care.

The paper that compared factors including weight loss, sexual experience (including sex drive, arousal, orgasm, and satisfaction), body image, depression and anxiety reported improvements in the total Sexual Experiences score and in sub-scores for drive, arousal and orgasm, but not in the satisfaction score six months after bariatric surgery among the female study participant.

The study researchers were from Şişli Hamidiye Etfal Research and Training Hospital Psychiatry Unit, Şişli-İstanbul, Bakirköy Sadi Konuk Research and Training Hospital, General Surgery Unit, Bakirköy-İstanbul and  Akdeniz University Department of Internal Medicine, Antalya, Nevşehir State Hospital, Psychiatry Unit, Nevsehir and Şişli Hamidiye Etfal Research and Training Hospital General Surgery Unit, Şişli-İstanbul, Turkey.

Despite the increase in bariatric surgery (BS) and its effectiveness in producing weight loss, it has also been found to improve anxiety and depression symptoms as well as sexual functions. To investigate this further, the study authors aimed to test three hypotheses:

  • The prevalence of sexual dysfunction measured by the Arizona Sexual Experiences Scale (ASEX)16 is high in female BS candidates;
  • Significant improvement in sexual function is seen in 6 months after BS; and
  • There is positive correlation between the ASEX scores and the Beck Depression Scale (BDS) scores, but there is negative correlation between the ASEX and the Body Image Scale (BIS) scores.

Study

In total, 31 patients who underwent laparoscopic sleeve gastrectomy and took part in the postoperative interview were included in the final analysis. The average age of the participants was 41.39±8.25, the average duration of obesity was 20.16±11.00 years and the average BMI49.70±7.87.

The authors reported that a statistically significant improvement was observed in the BMI and weight, BDS, BAS, and BIS scores (Table 1) of the patients compared to the preoperative term (p<0.001).

  Presurgery (n = 31) Postsurgery (n = 31)  
Variables Mean ± SD Mean ± SD p
BMI (kg/m2) 49.70 ± 7.87 33.39 ± 7.07 <0.001
Weight (kg) 128.38 ± 22.11 92.17 ± 20.50 <0.001
BDS 11.55 ± 8.00 2.94 ± 4.71 <0.001
BAS 10.65 ± 12.72 4.00 ± 6.61 <0.001
BIS 127.54 ± 24.91 173.64 ± 17.91 <0.001

Table 1: Evaluation of patients' preoperative and postoperative BMIs, weight loss rates and scale scores

An evaluation of the pre- and post-surgery ASEX subscores of the patients showed improvement in the total ASEX scores (p=0.005) as well as the ASEX-1 (drive), ASEX-2 (arousal) (p=0.001), and ASEX-4 (orgasm) (p=0.039) scores. However, no improvement was found in the ASEX-3 (lubrication) and ASEX-5 (satisfaction) scores (p>0.05).

The correlation of the post-surgical ASEX and BMI, BDS, BAS, and BIS scores showed a positive correlation between the ASEX scores and the BDS scores (p<0.05) and a negative correlation between the ASEX scores and the BIS scores (p<0.01).

Overall, the researchers said that women who underwent surgery reported an improvement in the sexual function, body image, and depression and anxiety levels 6 months after surgery. However, they acknowledge that due to cultural characteristics (traditional Islamic culture), some patients could have found it difficult to discuss their sex lives.

“In evaluating sexual functions in patients who underwent bariatric surgery, the level of depression should also be taken into consideration,” the authors conclude. “Although it is reported that the maximum recovery in post-BS sexual functions occurs especially in month six, the effect of bariatric surgery in sexual functions should be followed for long term and studies should be planned for larger sampling groups.”

The article is available free to download until 12 December 2015 and can be accessed here

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