Changes in Sexual Functioning and Sex Hormone Levels in Women Following Bariatric Surgery
Changes in Sexual Functioning and Sex Hormone Levels in Women Following Bariatric Surgery
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DOI：
10.1001/jamasurg.2013.5022
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发表时间：
2014-01-01
期刊：
影响因子：
16.9
通讯作者：
Christian, Nicholas J.
中科院分区：
文献类型：
--
作者：
Sarwer, David B.;Spitzer, Jacqueline C.;Christian, Nicholas J.
肥胖与女性性功能障碍和生殖激素的不良变化有关。相对较少的研究调查了减肥手术后这些领域的变化。目的探讨接受减肥手术的女性性功能、性激素水平和相关心理社会结构的变化。设计、环境和参与者：一项前瞻性队列研究，来自减肥手术纵向评估二期的106名接受减肥手术的女性（中位[四分位数范围]体重指数44.5[41.4-49.7]）。评估在2006年至2012年期间完成。干预措施：减肥手术由经减肥手术纵向评估认证的外科医生进行（85名妇女接受Roux-en-Y胃旁路手术，21名妇女接受腹腔镜可调节胃束带）。主要结果和测量方法：使用女性性功能指数评估性功能。通过血液化验来评估激素水平。生活质量、身体形象、抑郁症状和婚姻调整通过使用有效的问卷进行评估。结果：术后1年女性平均减轻32.7%（95% CI, 30.7%-34.7%）的初始体重，术后2年平均减轻33.5%（95% CI, 31.5%-35.6%）。手术后两年，女性报告在整体性功能和特定性功能方面有显著改善：性唤起、润滑、欲望和满意度。2年后，他们所有感兴趣的激素水平也发生了显著变化。妇女报告说，在手术后的第一年，她们在生活质量、身体形象和抑郁症状的大多数方面都有了显著改善，并在术后第二年保持了这些改善。结论和意义接受减肥手术的女性在整体性功能、大多数感兴趣的生殖激素和社会心理状态方面有显著改善。在与减肥手术相关的健康益处列表中，可以添加性健康的改善。
IMPORTANCE 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.DESIGN, SETTING, AND PARTICIPANTS 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.INTERVENTIONS 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).MAIN OUTCOMES AND MEASURES 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 AND RELEVANCE 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.