Weight-loss surgery can bring lasting improvement in sexual function

Weight-loss surgery has more benefits than simply slimming a patient down since it may also result in lasting improvements to sexual functioning, a new study suggests. 

In the multicentre study that included more than 2,000 men and women who had problems with sexual functioning before surgery, researchers found that more than half reported improvements in their sex lives within a year of the surgery. The improved functioning continued for most of these patients through five years of follow-up, the study team reports in “JAMA Surgery”. 

“Satisfaction with sexual life is improved by one year after bariatric surgery, and this improvement is maintained in both men and women by five years post-surgery,” said the study’s lead author, Kristine Steffen of the School of Pharmacy at North Dakota State University in Fargo. 

At the start of the study, the 1,607 women and 429 men included in the analysis had filled out questionnaires that asked about sexual function and satisfaction, and all had reported problems. The questions included whether, in the past month, the individual had “felt sexual desire or interest, that is, desire or interest to engage in any activity that is arousing to you, alone or with a partner”, as well as how often they had participated in sexual activity, how much their physical health had limited sexual activity and how satisfied overall they were with their sex lives. 

The questions were asked again one year and five years post-surgery. Prior to surgery 1,015 of 1,456 (69.7 per cent) women and 304 of 409 (74.3 per cent) men said they were not satisfied with their sex lives. Among the participants who were dissatisfied, 56 per cent of women and 49.2 per cent of men experienced meaningful improvements at one year. 

Specifically, men were 1.57 times more likely than they were before the surgery to experience improvements in the frequency of feeling sexual desire, 1.53 times more likely to experience improvements in the frequency of sexual activity, 3.97 times more likely to experience fewer physical limitations to having sex and 2.37 times more likely to experience improvements in satisfaction with their sex lives. 

Women were 1.5 times more likely a year post-surgery than before their operations to experience improvements in the frequency of feeling sexual desire, 1.53 times more likely to experience improvements in the frequency of sexual activity, 3.7 times more likely to experience fewer physical limitations to having sex and 2.11 times more likely to experience improvements in satisfaction with their sex lives. 

Many of these improvements lasted for a full five years. For those who had improvements at year one in physical limitations, for instance, three-quarters of the women and more than two-thirds of the men continued to report improvement at year five. 

“There were significantly fewer women who had improvements in frequency of desire, frequency of activity and degree to which physical health limits sexual activity at year five post-surgery compared with year one post-surgery,” Steffen noted in an email. 

“In women, early improvement in satisfaction with sexual life was maintained by year five. In men dissatisfied before surgery, early improvements were maintained by year five in all domains except the degree to which physical health limits sexual activity.” 

“[The new study] highlights the importance of looking beyond what we traditionally look at with bariatric surgery”, said Kimberley Steele of Johns Hopkins Medicine in Baltimore. “Traditionally we’re looking at weight-loss outcomes and outcomes related to weight loss, such as diabetes, cholesterol, hypertension and sleep apnoea.” 

Steele, who was not involved in the study, said she hopes it will raise awareness about “something that is not talked about that often: sexual function”. Almost 70 per cent of women and 74.3 per cent of men listed that as a problem for them preoperatively, she noted. 

“This was a nice way through validated surgery and a large cohort to show how weight loss through bariatric surgery improves sexual function and therefore quality of life,” Steele said. “More women than men seek bariatric surgery. By raising awareness that weight loss improved sexual dysfunction and therefore also quality of life, maybe this will encourage more men to consider the option of bariatric surgery.”