Prevalence and degree of sexual dysfunction in a sample of women seeking bariatic surgery

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island, USA.
Surgery for Obesity and Related Diseases (Impact Factor: 4.07). 08/2009; 5(6):698-704. DOI: 10.1016/j.soard.2009.07.004
Source: PubMed


Sexual functioning has been shown to be impaired in women who are obese, particularly those seeking bariatric surgery. However, most previous studies evaluating sexual function in these populations have not used validated measures. We used the validated Female Sexual Function Index (FSFI) to assess the prevalence of female sexual dysfunction (FSD) in a sample of >100 women evaluated for bariatric surgery.
The FSFI was administered to reportedly sexually active women during their preoperative evaluation. The scores for the individual FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) ranging from 0 (or 1.2) to 6 were summed to produce a FSFI total score (range 2-36). A FSFI total cutoff score of <or=26.55 was used to identify participants with FSD. The participants' FSFI total and domain scores were compared with previously published norms available for women diagnosed with female sexual arousal disorder and healthy controls.
Of the 102 women, 61 (59.8%) had FSFI total scores of <or=26.55, indicative of FSD. Older age and menopause were associated with FSD. Compared with published norms, bariatric surgery candidates had FSFI domain scores that were lower than those of the control group (all P values < 0.0001) but greater than those of the female sexual arousal disorder group (all P values < 0.0001), except for desire, for which the scores were similar.
Women seeking bariatric surgery are clearly a population with substantial sexual function impairment, with 60% of participants reporting FSD. These findings highlight the need to initiate routine assessment of sexual functioning in this population and examine whether the weight loss after bariatric surgery contributes to a reversal of FSD.

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    ABSTRACT: Both overweight and obesity have been identified as risk factors for sexual dysfunction in men, but the relationship between sexual function and amount of body fat in females is still obscure. There are few reported studies in women assessing the relationship between female sexual function index (FSFI) and body weight. The aim of this study was to identify the frequency of female sexual dysfunction (FSD) among obese and overweight women. A total of 45 obese and overweight and 30 age-matched voluntary healthy women serving as a control group were evaluated by a detailed medical and sexual history, including the FSFI questionnaire. Serum prolactin, cortisol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone-SO(4) (DHEA-S), testosterone, estradiol and sex hormone-binding globulin (SHBG) levels were measured. No significant difference was observed between controls and patients in terms of the FSH, LH, estradiol, free thyroxine and thyrotropin (TSH), testosterone and DHEA-S levels. The comparison of total FSFI scores between patients and controls showed no significant difference (P=0.74). As the FSFI score of <or=26.55 indicated FSD, 86% of obese patients and 83% of controls were considered to have sexual dysfunction. The mean total FSFI score was 22.1+/-4.3 for obese patients and 23.1+/-3.7 for healthy women. FSFI scores were not correlated with any of the anthropometric measurements (body mass index (BMI), waist-to-hip ratio (WHR) and fat percent). The levels of total testosterone and DHEA-S were not correlated with total FSFI scores. We found a significant negative correlation between BMI and orgasm (P=0.007, r=-0.413). Satisfaction was also negatively correlated with BMI (P=0.05, r=-0.305) and weight (P=0.03, r=-0.326). Testosterone levels were negatively correlated with only satisfaction domain scores of FSFI (P=0.01, r=-0.385). We found that 86% of obese women and 83% of controls had sexual dysfunction. Although obesity does not seem to be a major contributor to sexual dysfunction, it affects several aspects of sexuality.
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