ASMBS: Female Sexlife Better after WLS

On June 29, 2010, in Uncategorized, by Andrea

As many of you know, the ASMBS had their Annual Convention in Las Vegas last week and now the journals are starting to pour out a ton of information from that meeting.  I’ve been slacking of late, but I’m going to start putting in the things that they’ve churned out from the meeting as it directly relates to the WLS community.  Maybe not nutrition-wise, but still.

A post my father wouldn’t want to read, I’m sure..

From Medscape:

Obesity-Related Female Sexual Dysfunction Often Resolves With Bariatric Surgery

Nancy A. Melville

June 25, 2010 (Las Vegas, Nevada) — Obese women with female sexual dysfunction might have a complete resolution of symptoms after bariatric surgery for weight loss, according to a study presented here at the American Society for Metabolic and Bariatric Surgery 27th Annual Meeting.

Researchers at the Warren Alpert Medical School of Brown University in Providence, Rhode Island, found in an earlier study that as many as 60% of women seeking bariatric surgery have female sexual dysfunction (FSD), defined by the validated Female Sexual Function Index (FSFI). The index assesses sexual function across 6 domains on a scale of 2 to 36, with higher scores indicating better sexual function and a score of 26.55 and lower indicating female sexual dysfunction.

In a follow-up study to evaluate the effect that the surgery had on FSD, Dale S. Bond, PhD, assistant professor of psychiatry and human behavior at Miriam Hospital and Brown University, and colleagues evaluated 54 reportedly sexually active women who completed the FSFI.

Prior to surgery, 34 women (63%) had FSFI scores indicating female sexual dysfunction. Six months after the surgery, FSD had resolved in 23 of the patients (68%). Only 1 patient developed FSD after surgery.

The FSFI scores of the women who had FSD before surgery were in fact indistinguishable from published normal control scores 6 months after surgery (29.4 ± 4.3 vs 30.5 ± 5.3; P = .18).

Improvements in FSFI scores were seen across all 6 of the index’s domains and among all 38 patients receiving laparoscopic adjustable gastric banding (LAGB) (24.2 ± 5.9 to 29.1 ± 4.1; P < .001) and the 16 who underwent Roux-en-Y gastric bypass surgery (RYGB) (23.7 ± 7.7 to 30.0 ± 4.7; P < .001). There were no significant differences in the degree of improvement.

The mean 6-month postoperative excess weight loss among all patients was 42.3%. The mean weight loss among those who had LAGB was 34.6% (±15.7%), and for patients who underwent RYGB, the excess weight loss was 60.0% (±21.2%). However, similar improvements in FSFI scores were seen regardless of the percentage of excessive weight loss.

“It was surprising to us that weight loss wasn’t a significant independent predictor of improved FSFI scores,” Dr. Bond told Medscape General Surgery. “We expected it to be more of a predictor and it suggests that there’s a lower threshold in terms of weight loss improvement and sexual function.”

Regression analyses indicated “significant postop improvements in all of the sexual function domains, with the greatest improvement associated with younger age, being married, and worse preop sex function,” Dr. Bond said. “Postoperatively, patients’ scores were significantly improved, to levels that were indistinguishable from normative controls.”

Dr. Bond speculated that the improvement could be attributable to several psychological factors involved in the dramatic weight loss that occurs after bariatric surgery.

“There are numerous improvements in various aspects of the quality of life and mood that we can expect to see during this initial period,” he told Medscape General Surgery.

“It’s quite possible that these women just feel more confident in their body image and more comfortable as sexual beings. I think there might also be some physiological factors, such as improvement in their reproductive hormone profile, but we didn’t study this.”

He added that the substantial degree of improvement follows other changes brought about by weight loss surgery. “The resolution that we saw was similar to the degree of improvement in other comorbidities after surgery, so it kind of goes in line with so many other things that are improved.”

One important limitation of the study is that it only evaluated women 6 months after surgery; more data are needed to evaluate the longer-term effects, Bond said.

The first months after surgery are when “the weight loss is most dramatic; this may be kind of a glow period where everything is just clicking,” he explained.

“But we now have 2 studies showing the prevalence of FSD in obese women seeking surgery to be nearly as high as you would see in women with gynecological disorders and the degree of improvement they can have after surgery, so I think a crucial next study will be to see if this effect is sustained.”

Shahla Ray, PhD, from the Department of Applied Health Science at Indiana University in Bloomington, said she is not surprised that the degree of excess weight loss did not appear to influence the degree of improvement in sexual function.

“Even if there is a small amount of weight loss, women have more confidence, and that alone can make a big difference for some,” she explained. “There could be other factors, including an improved blood supply to the reproductive organs when there is significant weight loss, and if they’re getting more exercise, that can improve blood supply as well,” Dr. Ray said.

“The psychological impact of weight loss can be significant. One weight loss surgery patient told me that one of the biggest things for her was to be able to go to Victoria’s Secret and buy lingerie, so there really can be a renewed sense of sexuality.”

The study received a grant from the National Institute of Diabetes and Digestive and Kidney Diseases. Dr. Bond and Dr. Ray have disclosed no relevant financial relationships.

American Society for Metabolic and Bariatric Surgery (ASMBS) 27th Annual Meeting: Abstract PL-106. Presented June 24, 2010.

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