Bariatric Surgery Increases Testosterone and Improves Male Sexual Function. a Pilot Study of Thirteen Morbidly Obese Men.

Taehee Kwak, MD, Homayoun Pournik, MD, Krystyna Kabata, RPAC, Anthony Tortolani, MD, Piotr Gorecki, MD. New York Methodist Hospital, Brooklyn, NY, USA

Background: The effect of bariatric surgery on sex hormones and sexual function of morbidly obese men has not been well studied.
Objective: The purpose of this study was to examine the effect of bariatric surgery induced weight loss on testosterone level and sexual function in morbidly obese men.
Methods: Thirteen morbidly obese men who underwent bariatric surgery were followed for 1 year. All operations were performed by the same surgeon (PG) at a single institution. Total testosterone level and sexual quality of life were measured before and 1 year after the surgery. The previously validated Brief Male Sexual Function Inventory (BSFI) questionnaire was administered to evaluate sexual function. The questionnaire has 11 questions measuring: 1) sexual drive, 2) erectile function, 3) ejaculatory function, 4) assessment of problems with sexual drive, erection, or ejaculation, and 5) overall satisfaction with sex life. Each question is scored on a scale of 0-4, with higher scores indicating better functioning. Pearson correlation coefficients were computed between BMI, serum testosterone levels, and scores in each category of the BSFI questionnaire, as well as the changes after 1 year in each of these parameters.
Results: The mean age was 45.2 ± 14.2 yr. At baseline, mean weight was 307.4 ± 45.9 lb, BMI was 44.9 ± 4.5 Kg/m2, and serum total testosterone level was 311.6 ± 130.7 ng/dl. 77% (10 out of 13) of the men underwent laparoscopic adjustable gastric banding and 23% (3 out of 13) underwent laparoscopic Roux-en-Y gastric bypass. At 1 year follow-up, mean weight was 253.8 ± 45.93 lb (mean decrease: 53.6 ± 34.18 lb), BMI was 36.7 ± 5.2 Kg/m2 (mean decrease: 8.2 ± 4 Kg/m2), and total testosterone level was 458.2 ± 179.6 ng/dl (mean increase: 146.9 ± 142 ng/dl). Six men answered the questionnaire both before and after surgery, and their baseline mean scores (± S.D.) for sexual drive, erection, ejaculation, problem assessment, and overall satisfaction were 2.3 (± 0.9), 2.6 (± 0.9), 3.6 (± 0.5), 3.2 (± 0.9), and 2.7 (± 1.0), respectively. At 1 year, mean scores were 3.1 (± 0.8), 3.2 (± 0.9), 3.8 (± 0.4), 3.4 (± 0.8), and 3.0 (± 0.9), respectively, and all increased. Increases in four categories (sexual drive, erection, problem assessment, and overall satisfaction) were statistically significant (p<0.05). Correlation coefficients calculated between decreases in BMI, increases in testosterone level, and changes in questionnaire scores were all in the expected direction but not statistically significant, likely due to the currently small sample size in this ongoing study.
Conclusions: Our results demonstrate that testosterone level and sexual quality of life in morbidly obese men were significantly improved after bariatric surgery. While a limited number of men have completed the questionnaire to date, this pilot study suggests potential effects of bariatric surgery on improving sexual function related quality of life in morbidly obese men.
 

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