Effects of bariatric surgery on testosterone level and sexual function in men with obesity: A retrospective study

Abstract

IntroductionBariatric surgeries induce well-documented weight loss and resolve obesity comorbidities. Sexual function is one of the aspects of life quality and may benefit from surgery. Few studies have revealed the impact of bariatric surgeries on sexual function in Chinese men with obesity.MethodsThis is a retrospective cohort study of patients undergoing bariatric surgery [laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB)]. Data were collected between September 2017 and February 2022. The International Index of Erectile Function (IIEF) questionnaire was used to evaluate erectile function, intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction. Sex hormones and other blood tests were evaluated before and at least 1 year after the surgery.ResultsFifty-nine Chinese male patients completed the IIEF questionnaire. The multivariate logistic regression analysis revealed that body mass index (BMI) was the single independent risk factor of the severity of erectile dysfunction (ED). Preoperative testosterone levels had negative correlations with BMI and waist circumference. Thirty-seven patients completed the postoperative questionnaire with a mean follow-up of 23.2 months.ConclusionBMI and waist circumference were negatively correlated with testosterone levels. BMI was an independent risk factor for the severity of ED. LSG and LRYGB led to positive and sustained improvement in sexual function of men with obesity. The two procedures had a comparable effect, more subjects being needed. Sex hormone levels also could be reversible. However, more weight loss did not predict a positive change in sexual function. A greater BMI loss might predict a greater increase in testosterone.

Relation between athletic club affiliation from school age and future serum free testosterone levels in Japan: A cross‐sectional study

“…BMI and waist circumference were negatively correlated with testosterone levels, although BMI was not associated with low testosterone levels in this study 24 . Some Japanese studies have found no association between BMI and low‐testosterone, similar to this study 9 .…”

“…BMI and waist circumference were negatively correlated with testosterone levels, although BMI was not associated with low testosterone levels in this study. 24 Some Japanese studies have found no association between BMI and low-testosterone, similar to this study. 9 The prevalence of obesity and overweight in Japanese adults is rather low in international comparisons 25 and could explain why BMI was not a significant factor in this study.…”

Meta‐analysis and construction of simple‐to‐use nomograms for approximating testosterone levels gained from weight loss in obese men

“…The remaining 44 studies comprising 1,774 participants met the search criteria (Figure 1). 18–60 In total, there were 2,159 datasets as some studies included several datasets from the same group of participants, but at different time points. The ranges (lowest to highest) of baseline mean age, 21–68 years; BMI.…”

“…Four studies were considered to suffer bias due to deviations from intended interventions as weight‐loss treatment was relatively short (≤ 4 weeks), 18,34,52,56 and one LCD study with the addition of the glucagon‐like peptide‐1 agonist Exenatide), 33 and two LCD studies used very low‐calorie ketogenic diet (35,36) 35,36 . Data for free testosterone were not reported in 12 studies 22,28,35,36,38,42,47–49,51,53,60 . None of the studies had a bias in the measurement of outcomes, while there was insufficient information from any of the studies for assessing bias in the selection of the reported result (Figure 5).…”

“…35,36 Data for free testosterone were not reported in 12 studies. 22,28,35,36,38,42,[47][48][49]51,53,60 None of the studies had a bias in the measurement of outcomes, while there was insufficient information from any of the studies for assessing bias in the selection of the reported result (Figure 5).…”