Sexual function in obese women: impact of lower urinary tract dysfunction

Abstract

Objective: To assess the impact on sexual function attributed to lower urinary tract dysfunction in a female obese population. Design: We performed a case-control study based on the registry of a university hospital obesity unit. A consecutive sample of women with body mass index(BMI) X30 (obese) was randomly matched by age, gender and residential county to control subjects using the computerized Register of the Total Population. Data were collected by a self-reported postal survey including the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Results: The questionnaire was completed and returned by 279/446 patients (62%) and 430/892 control subjects (48%). Obese women reported significantly lesser satisfaction with their sexual life, more frequent symptoms of urinary incontinence at intercourse, more often fear of urine leakage at intercourse, a higher tendency toward avoiding intercourse and more frequent feelings of guilt and disgust during intercourse (Po0.001). While considering sexual function in a subset of women with urge or stress urinary incontinence, the overall PISQ-12 scores were significantly lower in obese women compared to their age-matched nonobese controls for both the conditions (Po0.001). In an adjusted multivariate analysis, a BMI 430 was independently associated with a significantly increased risk for sexual dysfunction (odds ratio (OR) 1.8; 95% confidence interval (CI) 1.1-2.9), as were symptoms of urge or stress urinary incontinence (OR, 2.0; 95% CI, 1.3-3.1 and OR, 2.6; 95% CI, 1.7-4.0), respectively. Conclusion: Urge and stress urinary incontinences are more common and have greater impact on sexual function in obese women.

Body mass index, urinary incontinence, and female sexual dysfunction

“…28,29 Recently, a few reports have brought new perspectives into the relationship between female sexuality and weight, showing an increased prevalence of FSD among overweight women. 13,26,29,30 Our data seem to confirm these observations of a possible association of obesity with several aspects of female sexual function; in particular, in perimenopausal and postmenopausal obese women, arousal (r = j0.82), orgasm (r = j0.72), lubrication (r = j0.61), and satisfaction (r = j0.63, all P G 0.001) showed an inverse significant correlation with BMI, whereas it was not accounted for by the desire and pain domain of FSFI score. Because the results can vary between studies for different reasons, the relationship between sexual function and obesity is still controversial.…”

“…Obesity as a major determinant of UI onset and altered female sexual function, due to increased weight, has always been analyzed separately in previous reports. 13,14,[32][33][34] To our knowledge, this is the first study of a perimenopausal and postmenopausal overweight/obese population, that evaluated weight gain, UI, and FSD simultaneously, in an attempt to better understand the impact and the interconnecting causal relationships of these three factors on postmenopausal female health. Several risk factors have long been known to be associated with the occurrence of UI among postmenopausal women such as hysterectomy, diabetes, and vaginal symptoms.…”

“…Furthermore, in obese women, female UI deeply affects sexual function, as demonstrated by significantly decreased satisfaction with their sexual life, more frequent symptoms of UI, fear of urine leakage during intercourse, higher tendency toward avoiding intercourse, and more frequent feelings of guilt and disgust during intercourse. 13,14 Our aims were to evaluate the effect of BMI on UI onset and severity and to assess how obesity and UI, together, affect female sexual function. For this purpose, we enrolled a selected perimenopausal and postmenopausal population grouped into three different categories on the basis of BMI (normal, overweight, and obese).…”

Impact of bariatric surgery on female reproduction

“…Obesity has been shown to be associated with a significantly increased risk for sexual dysfunction (92). Moreover, women with the metabolic syndrome secondary to obesity have increased prevalence of sexual dysfunction when compared with matched control women (93).…”

Association of Body Weight and Female Sexual Dysfunction: A Case Control Study

“…Obesity is a significant public health problem, which is quickly increasing worldwide (1-3). In 2005, according to WHO estimate, approximately 1.6 billion adults were overweight and at least 400 million adults were obese worldwide (4).…”