Obesity Surgery

, Volume 28, Issue 4, pp 892–899 | Cite as

4-Year Changes in Sex Hormones, Sexual Functioning, and Psychosocial Status in Women Who Underwent Bariatric Surgery

  • David B. SarwerEmail author
  • Thomas A. Wadden
  • Jacqueline C. Spitzer
  • James E. Mitchell
  • Kathy Lancaster
  • Anita Courcoulas
  • William Gourash
  • Raymond C. Rosen
  • Nicholas J. Christian
Original Contributions



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.


Sex 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.

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.

Supplementary material

11695_2017_3025_MOESM1_ESM.docx (24 kb)
ESM 1 (DOCX 23 kb).


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • David B. Sarwer
    • 1
    Email author return OK on get
  • Thomas A. Wadden
    • 2
  • Jacqueline C. Spitzer
    • 1
  • James E. Mitchell
    • 3
  • Kathy Lancaster
    • 3
  • Anita Courcoulas
    • 4
  • William Gourash
    • 4
  • Raymond C. Rosen
    • 5
  • Nicholas J. Christian
    • 6
  1. 1.Center for Obesity Research and Education, College of Public HealthTemple UniversityPhiladelphiaUSA
  2. 2.Department of Psychiatry, Center for Weight and Eating DisordersPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA
  3. 3.Neuropsychiatric Research Institute and the University of North Dakota School of Medicine and Health SciencesFargoUSA
  4. 4.University of Pittsburgh Medical CenterPittsburghUSA
  5. 5.New England Research InstitutesWatertownUSA
  6. 6.Graduate School of Public HealthUniversity of PittsburghPittsburghUSA

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