4-Year Changes in Sex Hormones, Sexual Functioning, and Psychosocial Status in Women Who Underwent Bariatric Surgery
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Initial weight loss after bariatric surgery has been associated with improvements in reproductive hormones and sexual functioning in women. Few studies have investigated the durability of these changes.
The objective of this paper is to investigate changes in sex hormones, sexual functioning, and relevant psychosocial constructs over 4 years in women who underwent bariatric surgery.
The setting is a prospective cohort of 106 women from the Longitudinal Assessment of Bariatric Surgery consortium.
Changes in sex hormones were assessed by blood assay. Sexual functioning, quality of life (QOL), body image, depressive symptoms, and marital adjustment were assessed by psychometric measures.
Women lost on average (95% confidence interval) 32.3% (30.4%, 34.3%) at postoperative year 3 and 30.6% (28.5%, 32.8%) at postoperative year 4. Compared to baseline, women experienced significant changes at 4 years in all hormones assessed, except estradiol. Women reported significant improvements in sexual functioning (i.e., arousal, desire, and satisfaction) through year 3, but these changes were not maintained through year 4. Changes in relationship quality followed a similar pattern. Improvements in physical aspects of QOL, body image, and depressive symptoms were maintained through 4 years.
Improvements in reproductive hormones and physical aspects of QOL, body image, and depressive symptoms were maintained 4 years after bariatric surgery. Improvements in sexual functioning, relationship satisfaction, and mental components of QOL eroded over time.
KeywordsSex hormones Sexual functioning Quality of life Psychosocial status Bariatric surgery
This ancillary study to the Longitudinal Assessment of Bariatric Surgery-2 was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant no. R01DK072452.
Compliance with Ethical Standards
Conflict of Interest
During the time of the study, Dr. Sarwer served as a paid consultant for Allergan, BariMD, BAROnova, EnteroMedics, and Ethicon Endo-Surgery, which are manufacturers of products for non-surgical weight loss treatment and bariatric surgery. At the time of the conduct of the study, he also was on the board of directors of the Surgical Review Corporation, which created the International Center of Excellence for Bariatric Surgery program to evaluate bariatric surgeons and hospitals around the world. Dr. Wadden serves on advisory boards for Novo Nordisk, Nutrisystem, and Orexigen Pharmaceuticals. Dr. Courcoulas has received research grants from Allergan, Pfizer, Covidien, EndoGastric Solutions, and Nutrisystem and is on the Scientific Advisory Board of Ethicon J & J Healthcare System. Dr. Mitchell, Ms. Spitzer, Ms. Lancaster, Mr. Gourash, and Dr. Christian have no relationships to disclose.
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.
- 12.Turcato E, Zamboni M, De Pergola G, et al. Interrelationships between weight loss, body fat distribution and sex hormones in pre- and postmenopausal obese women. J Intern Med. 1997;241(5):363–72. https://doi.org/10.1046/j.1365-2796.1997.120129000.x.CrossRefPubMedGoogle Scholar
- 15.Belle SH, Berk PD, Chapman WH, et al. Baseline characteristics of participants in the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study. Surg Obes Relat Dis.[published online ahead of print March 7, 2013]. https://doi.org/10.1016/j.soard.2013.01.023.
- 20.Ware JE, Snow KK, Kosinski M, et al. SF-36 health survey manual and interpretation guide. Boston: New England Medical Center, The Health Institute; 1993.Google Scholar
- 21.Kolotkin RL, Head S, Hamilton M, et al. Assessing the impact of weight on the quality of life. Obes Res. 1995;3(1):49–56. https://doi.org/10.1002/j.1550-8528.1995.tb00120.x.CrossRefPubMedGoogle Scholar
- 23.Kolotkin RL, Crosby RD. Manual for the Impact of Weight on Quality of Life Measure (IWQOL and IWQOL-Lite). Durham: Obesity and Quality of Life Consulting; 2011.Google Scholar
- 25.Cooper PJ, Taylor MJ, Cooper Z, et al. The development and validation of the body shape questionnaire. Int J Eat Disord. 1987;6(4):485–94. https://doi.org/10.1002/1098-108X(198707)6:4<485::AID-EAT2260060405>3.0.CO;2-O.CrossRefGoogle Scholar
- 26.Spanier GB. Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. J Marital Fam Ther. 1976;38(2):15–38.Google Scholar
- 27.Beck AT, Steer RA, Brown GK. Beck depression inventory II (BDI-II) manual. San Antonio: Harcourt Brace; 1993.Google Scholar