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Sexualität bei Übergewicht und Adipositas

Sexuality in overweight and obesity

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Zusammenfassung

Die Assoziation zwischen Adipositas und Sexualfunktionsstörungen ist in vielen Studien beschrieben. Neurobiologische, hormonelle und vaskuläre Störungen sowie psychische Erkrankungen gelten bei beiden Geschlechtern als Hauptursachen. Sexuelles Interesse und Verlangen, sexuelle Erregung, Orgasmus, schmerzhafter Geschlechtsverkehr und Ejakulation können betroffen sein. Die Datenlage zu Prävalenzzahlen für Sexualfunktionsstörungen bei adipösen Menschen ist aufgrund der Studien mit kleinen Fallzahlen beschränkt. Für das Screening von Sexualfunktionsstörungen stehen zwei validierte Scores zur Verfügung. Der Internationale Index of Erectile Function-5 (IIEF5), der 15 Fragen enthält und der Female Sexual Function Index (FSFI), der 19 Fragen enthält sind multidimensionale und validierte diagnostische Methoden für das jeweilige Geschlecht. Die Behandlung umfasst Lebensstilveränderungen mit vermehrter körperlicher Aktivität, Gewichtskontrolle, gesunde Ernährung und Beendigung von Tabakkonsum. Testosteron Substitution in Fällen eines nachgewiesenen Hypogonadismus und Therapie mit PDE-5 Inhibitoren sind gut dokumentierte Behandlungsoptionen bei Männern. Therapieoptionen für Frauen sind nicht so gut evaluiert, wobei Fibanserin, Testosteron, Bupropion und Oxytocin wirksam sein dürften.

Summary

The association between obesity and sexual dysfunction has been described in many studies. Neurobiological, hormonal, vascular and mental disturbances are the main reasons in male and in female gender. Sexual interest and desire, sexual arousal, orgasm, painful intercourse and premature ejaculation can be involved. Data for prevalence of sexual function disturbances in obese people are scarce and most studies were small. For screening of sexual function we recommend the International Index of Erectile Function (IIEF)-Score, which contains 15 Items for males and the Female Sexual Function Index (FSFI), which contains 19 items for females. Treatment of sexual function disturbances include lifestyle changes with an increase of physical activity, weight control, healthy eating and smoking cessation. Testosterone substitution in cases of real hypogonadism and treatment with PDE-5 inhibitors are well documented treatment options in male individuals. New treatment options for female patients with variable effectiveness are fibanserin, testosterone, bupropione and oxytocin.

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Danksagung

Wir danken A Ponholzer und E Bragnana für die Unterstützung bei der Erstellung dieses Beitrages.

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Authors and Affiliations

  1. Internistisches Zentrum, Otto Wagner Spital, Baumgartner Höhe 1, 1140, Wien, Österreich

    Heidemarie Abrahamian

  2. Universitätsklinik für Innere Medizin III, Währinger Gürtel 18-20, 1090, Wien, Österreich

    Alexandra Kautzky-Willer

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  1. Heidemarie Abrahamian
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  2. Alexandra Kautzky-Willer
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Correspondence to Heidemarie Abrahamian.

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H. Abrahamian und A. Kautzky-Willer geben an, dass kein Interessenkonflikt besteht.

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Abrahamian, H., Kautzky-Willer, A. Sexualität bei Übergewicht und Adipositas. Wien Med Wochenschr 166, 121–128 (2016). https://doi.org/10.1007/s10354-016-0430-9

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