Weight loss by multidisciplinary intervention improves endothelial and sexual function in obese fertile women.
BACKGROUND
Weight loss in sexually active women improves their quality of life. At present, no studies have investigated whether weight loss may affect female sexual function in severe obese women.


OBJECTIVE
The aim of this study was to investigate the effects of different programs of weight loss on female sexual dysfunction complaints and on endothelial function in premenopausal obese females.


METHODS
Forty-four out of overall 80 obese fertile women (age 18-49 years; mean 36 years) were enrolled because of sexual complaints at Female Sexual Function Index-6 (FSFI-6 score ≤19). Patients were then allocated to different treatments of 8 weeks duration each: an intensive residential program with hypocaloric diet plus controlled physical exercise along with lifestyle modifications at a specialized clinic (Group A, N = 23) and a non-intensive outpatient clinic program consisting of hypocaloric diet and physical exercise at home (Group B, N = 21). Afterward, overall patients were allocated to an extended 8-week follow-up period consisting of outpatient clinic controlled diet plus physical exercise at home.


METHODS
Primary end points were modifications of FSFI-6 scores and endothelial function as measured by reactive hyperemia (RHI) with EndoPat-2000. Secondary end points were modifications in body composition as measured by dual-energy X-ray absorptiometry (DEXA).


RESULTS
After 16 weeks, FSFI-6 score and the frequency of sexual activity were significantly higher in Group A compared with Group B (P < 0.01), and significant improvements in arousal, lubrication, and satisfaction sub-domain scores were also found (P < 0.01). Group A showed improvements in RHI (P < 0.01) and marked improvement in homeostasis model assessment of insulin resistance (P < 0.001), anthropometric parameters as weight (P < 0.01), body mass index (P < 0.01), fat mass (P < 0.0001), and percentage of fat mass (P < 0.005) compared with Group B. A relationship between peak insulin (P < 0.0001) and RHI (P < 0.001) vs. FSFI-6 scores was found, respectively.


CONCLUSIONS
A multidisciplinary approach to female obesity appears to be superior to conventional outpatient clinic to produce weight loss and to improve several aspects of sexual dysfunction in obese women. Such changes might be related to persistent improvements in endothelial function and in insulin resistance.
Department of Experimental Medicine, Medical Physiopathology, Food Science and Endocrinology Section, Viale Policlinico 155,Rome, Italy. antonio.aversa@uniroma1.it
Antonio
A
Aversa
Roberto
R
Bruzziches
Davide
D
Francomano
Emanuela A
EA
Greco
Francesco
F
Violi
Andrea
A
Lenzi
Lorenzo M
LM
Donini
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D001823:Body Composition / Q000502:physiology; D002097:C-Reactive Protein / Q000032:analysis; D004038:Diet, Reducing; D004730:Endothelium, Vascular / Q000502:physiology*; D015444:Exercise; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D015438:Health Behavior; D006760:Hospitalization; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000628:therapy*; D010044:Outpatient Clinics, Hospital; D010348:Patient Care Team; D017697:Premenopause; D012735:Sexual Dysfunction, Physiological / Q000628:therapy*; D020018:Sexual Dysfunctions, Psychological / Q000628:therapy*; D015431:Weight Loss; D055815:Young Adult
D007328:Insulin; D005340:Fibrinogen; D002097:C-Reactive Protein