title: Changes in sexual functioning and sex hormone levels in women following bariatric surgery.
abstract: OBJECTIVE
  Obesity has been associated with impairments in sexual function and untoward changes in reproductive hormones in women. Relatively few studies have investigated changes in these domains following bariatric surgery.
  
  
  OBJECTIVE
  To investigate changes in sexual functioning, sex hormone levels, and relevant psychosocial constructs in women who underwent bariatric surgery.
  
  
  METHODS
  A prospective cohort study of 106 women from phase 2 of the Longitudinal Assessment of Bariatric Surgery who underwent bariatric surgery (median [interquartile range] body mass index, 44.5 [41.4-49.7]). Assessments were completed between 2006 and 2012.
  
  
  METHODS
  Bariatric surgery was performed by a surgeon certified by the Longitudinal Assessment of Bariatric Surgery (85 women underwent a Roux-en-Y gastric bypass, and 21 women underwent laparoscopic adjustable gastric banding).
  
  
  METHODS
  Sexual functioning was assessed by use of the Female Sexual Function Index. Hormones were assessed by use of a blood assay. Quality of life, body image, depressive symptoms, and marital adjustment were assessed by use of validated questionnaires.
  
  
  RESULTS
  Women lost a mean 32.7% (95% CI, 30.7%-34.7%) of initial body weight at postoperative year 1 and a mean 33.5% (95% CI, 31.5%-35.6%) at postoperative year 2. Two years following surgery, women reported significant improvements in overall sexual functioning and specific domains of sexual functioning: arousal, lubrication, desires, and satisfaction. They also experienced significant changes at 2 years in all hormones of interest. Women reported significant improvements in most domains of quality of life, as well as body image and depressive symptoms, within the first year after surgery, with these improvements being maintained through the second postoperative year.
  
  
  CONCLUSIONS
  Women who underwent bariatric surgery had significant improvements in overall sexual functioning, in most reproductive hormones of interest, and in psychosocial status. Improvements in sexual health can be added to the list of health benefits associated with bariatric surgery.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00670098.
authors.affiliation: Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia2Department of Surgery, Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania.
authors.forename: David B
authors.initials: DB
authors.lastname: Sarwer
authors.affiliation: Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: Jacqueline C
authors.initials: JC
authors.lastname: Spitzer
authors.affiliation: Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
authors.affiliation: Neuropsychiatric Research Institute and the University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.affiliation: Neuropsychiatric Research Institute and the University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Lancaster
authors.affiliation: University of Pittsburgh Medical Center, Pennsylvania.
authors.forename: Anita
authors.initials: A
authors.lastname: Courcoulas
authors.affiliation: University of Pittsburgh Medical Center, Pennsylvania.
authors.forename: William
authors.initials: W
authors.lastname: Gourash
authors.affiliation: New England Research Institutes, Watertown, Massachusetts.
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Rosen
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Christian
mesh_terms: D000328:Adult; D005260:Female; D015390:Gastric Bypass; D015391:Gastroplasty; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery; D011446:Prospective Studies; D012735:Sexual Dysfunction, Physiological / Q000097:blood* / Q000209:etiology; D020018:Sexual Dysfunctions, Psychological / Q000097:blood* / Q000209:etiology
chemical_list: D012739:Gonadal Steroid Hormones