Resolution of Female Sexual Dysfunction (FSD) Among the Obese Multiethnic Malaysian Women Now a Reality with Bariatric Surgery: a Prospective Pilot Study in Malaysia

  • Sivaneswaran LechmiannandanEmail author
  • Mayurran Panirselvam
  • Prema Muninathan
  • Narwani Hussin
  • Reynu Rajan
  • Hatta Sidi
  • Nik Ritza Kosai
  • C. Rajkumar Vinayak
Original Contributions



Female sexual dysfunction (FSD) among the obese women is often under diagnosed and ignored especially in Malaysia, a nation of conservative multiethnic society. There are only a few studies on FSD resolution post-bariatric surgery. The objective was to identify the rate and resolution or improvement of FSD, among obese multiethnic Malaysian women post-bariatric surgery.

Material and Methods

This is a prospective study of women undergoing bariatric surgery, between May 2017 and April 2018. FSD was diagnosed using the Malay version of Female Sexual Function Index (MVFSFI) questionnaire. Patients filled up the questionnaire before and 6 months after surgery. Association between BMI reduction and FSFI score improvement was measured using Fisher’s exact test. Outcomes between types of surgery (sleeve gastrectomy and gastric bypass) was compared.


Fifty-two women completed the study. The mean age was 38.77 ± 6.7. There were 44 (84.6%) Malay patients, 7 (13.5%) Indian patients, and 1 (1.9%) Chinese patient. There was a significant reduction in mean BMI, 39.89 ± 6.9 pre-surgery to 30.32 ± 5.4 post-surgery (p value < 0.001). The rate of FSD among the obese is 75.0% pre-surgery compared to 36.0% post-surgery. There was a significant improvement in mean FSFI score pre- and post-surgery: 18.73 and 25.93 respectively and in each of all 6 domains (p value < 0.001). There was a significant association between BMI reduction and improvement in FSFI score (p = 0.019). There was no difference in outcomes between types of surgery.


FSD is highly prevalent among the obese multiethnic Malaysian women. Bariatric surgery has proven benefit in resolving FSD across all sexual domains and should be considered as a management option in this group of women.


Sexual dysfunction Women Female Bariatric surgery Female sexual function index Malay version female sexual function index 



We would like to thank the Director General of Health Malaysia for his permission to publish this article. We would also like to thank Dr. Khoo Say Chuan, Consultant Urologist, Department of Urology, Hospital Pulau Pinang, Dr. Jeffrey Lee Jiajian, Medical Officer, Department of Urology, Hospital Pulau Pinang, and Dr. Umasangar Ramasamy, Consultant General Surgeon, Department of Surgery, Hospital Taiping, for their support and pearls of wisdom throughout the course of this research.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyHospital Pulau PinangGeorgetownMalaysia
  2. 2.Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Faculty of MedicinePusat Perubatan Universiti Kebangsaan MalaysiaKuala LumpurMalaysia
  3. 3.Clinical Research CentreHospital TaipingTaipingMalaysia
  4. 4.Department of Psychiatry, Faculty of MedicinePusat Perubatan Universiti Kebangsaan MalaysiaKuala LumpurMalaysia
  5. 5.Bariatric Surgery Unit, Department of SurgeryHospital TaipingTaipingMalaysia

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