Obesity brings about many health problems, and by now the association between obesity and several health issues such as cardiovascular diseases has been thoroughly documented. However, its effects on sexual health have not been studied that well, and consequently, the effect of countermeasures such as bariatric surgery on sexual health have also not received that much attention.
For many of us, sexual health is an important facet of our perception of the quality of our life, and its significance cannot be overstated.
Aware of the gaps in knowledge with regard to sexual health after weight loss surgery, a research team from the University of Pennsylvania sought to determine exactly what effects bariatric surgery had on a woman’s reproductive and sexual health.
A LABS Study
The researchers used data from a LABS 2 study. LABS is the acronym for Longitudinal Assessment of Bariatric Surgery, a program that was started in the US in 2003 to evaluate the effects of bariatric surgery. It is divided into 3 parts, LABS 1, 2 and 3. LABS 1 evaluated the short term effects of bariatric surgery, LABS 2 evaluates the long term effects, and LABS 3 evaluates the physiological and psychosocial aspects of LABS 2 candidates.
LABS 2 is an ongoing study. The program started in enrolling participants 2006, and completed the process in 2009. A total of 2,400 participants were recruited for the study. For the purposes of this study, participants were required to be in a relationship for at least a year, so that they would have the chance for sexual activity. They were also required to be willing to undergo what would be their first bariatric surgery.
From a total of 147 women who had consented to participating in the study, only 106 were found eligible. These women would then fill in questionnaires relating to several aspects of their health, including sexual health, before and after surgery. Similarly, blood samples were to be taken pre and post-surgery for assays.
85 women underwent Roux-en-Y gastric bypass surgery, while the remaining 21 underwent laparoscopic adjustable gastric banding.
A Litany of Questionnaires
The participants filled 7 questionnaires, the most important of which, in relation to the focus of the study, was the Female Sexual Function Index (FSFI). The FSFI comes with 19 questions that evaluate 6 areas of sexual functioning: orgasm, satisfaction, pain, arousal, desire and lubrication. Desire and satisfaction have a lower threshold of 1.2 and 0.8 respectively, while the rate start at 0. The maximum possible value for each of these domains is 6, and a total score at or below 26 indicates sexual dysfunction.
A Short Form Health Survey was also filled to evaluate the quality of life in terms of general health, while the Impact of Weight on Quality of Life-Lite was used to evaluate the impact of weight on work, sex, self-esteem, physical function and public distress. Other forms that were filled were: The Body Image Quality of Life Inventory, The Body Shape Questionnaire, the Dyadic Adjustment Scale and the Beck Depression Inventory.
In addition to the questionnaires, blood samples were taken from the participants and tested for hormones important in sexual and reproductive health. The hormones tested were: follicle stimulating hormone (FSH), estradiol, luteinizing hormone (LH) DHEA-S, total testosterone and sex hormone binding globulin.
As participants in the LABS 2 study, the women receive follow ups annually, but the researchers limited themselves to the second year of follow up, as this often marks the point when a person who has undergone bariatric surgery experiences the greatest weight loss.
The Weight Tumbles, Sexual Functioning Goes Up
In the first year of checkup, the women lost an average of 32.7% of their body weight, and in the second year that average had risen to 33.5%. Concomitantly, blood tests showed that there were improvements in hormonal levels, especially in those women whose values had been very low to begin with. DHEA-S took a while to rise, but it had done so by the second year.
Scores taken from the FSFI also showed that the women were enjoying improvements in many other aspects, notably arousal, desires and satisfaction. In terms of psychosocial health, the women became more positive about their body images after bariatric surgery.
Limitations of the study
While the whole experiment was generally fine, the researchers noted that the participants were predominantly white and highly educated, making it hard to draw conclusions about women from other races with different levels of education. Also, because they couldn’t get data on menstrual cycles or menopause status, the researchers were forced to extrapolate potential fertility benefits solely on the changes in sex hormones.
All the same, it is clear that bariatric surgery can help you greatly get your groove back.