Abstract
Introduction
Female sexual dysfunction (FSD) among the obese women is often under diagnosed and ignored especially in Malaysia, a nation of conservative multiethnic society. There are only a few studies on FSD resolution post-bariatric surgery. The objective was to identify the rate and resolution or improvement of FSD, among obese multiethnic Malaysian women post-bariatric surgery.
Material and Methods
This is a prospective study of women undergoing bariatric surgery, between May 2017 and April 2018. FSD was diagnosed using the Malay version of Female Sexual Function Index (MVFSFI) questionnaire. Patients filled up the questionnaire before and 6 months after surgery. Association between BMI reduction and FSFI score improvement was measured using Fisher’s exact test. Outcomes between types of surgery (sleeve gastrectomy and gastric bypass) was compared.
Results
Fifty-two women completed the study. The mean age was 38.77 ± 6.7. There were 44 (84.6%) Malay patients, 7 (13.5%) Indian patients, and 1 (1.9%) Chinese patient. There was a significant reduction in mean BMI, 39.89 ± 6.9 pre-surgery to 30.32 ± 5.4 post-surgery (p value < 0.001). The rate of FSD among the obese is 75.0% pre-surgery compared to 36.0% post-surgery. There was a significant improvement in mean FSFI score pre- and post-surgery: 18.73 and 25.93 respectively and in each of all 6 domains (p value < 0.001). There was a significant association between BMI reduction and improvement in FSFI score (p = 0.019). There was no difference in outcomes between types of surgery.
Conclusion
FSD is highly prevalent among the obese multiethnic Malaysian women. Bariatric surgery has proven benefit in resolving FSD across all sexual domains and should be considered as a management option in this group of women.
Similar content being viewed by others
References
Ponholzer A, Roehlich M, Racz U, et al. Female sexual dysfunction in a healthy Austrian cohort: prevalence and risk factors. Eur Urol. 2005;47(3):366–74.
Martins e Silva B, Rêgo LM, Galvão MA, et al. Incidence of sexual dysfunction in patients with obesity and overweight. Rev Col Bras Cir. 2013;40(3):196–202.
Sidi H, Puteh SE, Abdullah N, et al. The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in Malaysian women. J Sex Med. 2007;4(2):311–21.
Kral JG. Surgical treatment of obesity. In: Bray GH, Bouchard C, James WP, editors. Handbook of obesity. New York: Marcel Dekker; 1997. p. 977–85.
Mason EE. Vertical banded gastroplasty for obesity. Arch Surg. 1982;117(5):701–6.
Arias E, Martínez PR, Ka Ming Li V, et al. Mid-term follow-up after sleeve gastrectomy as a final approach for morbid obesity. Obes Surg. 2009;19(5):544–8.
Colquitt JL, Clegg AJ, Loveman E, Royle P, Sidhu MK. Surgery for morbid obesity. Cochrane Database Syst Rev 2005;(4):CD003641. https://doi.org/10.1002/14651858.CD003641.pub2.
Benotti PN, Wood GC, Carey DJ, et al. Gastric bypass surgery produces a durable reduction in cardiovascular disease risk factors and reduces the long-term risks of congestive heart failure. J Am Heart Assoc. 2017;6(5):e005126. https://doi.org/10.1161/JAHA.116.005126.
Edwards C, Rogers A, Lynch S, et al. The effects of bariatric surgery weight loss on knee pain in patients with osteoarthritis of the knee. Arthritis. 2012;2012:504189.
Bond DS, Wing RR, Vithiananthan S, et al. Significant resolution of female sexual dysfunction after bariatric surgery. Surg Obes Relat Dis. 2011;7(1):1–7.
Janik MR, Bielecka I, Paśnik K, et al. Female sexual function before and after bariatric surgery: a cross-sectional study and review of literature. Obes Surg. 2015;25(8):1511–7.
Kasama K, Mui W, Lee WJ, et al. IFSO-APC consensus statements 2011. Obes Surg. 2012;22:677–84.
Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26:191–208.
Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cut-off scores. J Sex Marital Ther. 2005;31:1–20.
Sidi H, Abdullah N, Puteh SEW, et al. The Female Sexual Function Index (FSFI): validation of the Malay version. J Sex Med. 2007;4(6):1642–54.
Dziurowicz-Kozłowska A, Lisik W, Wierzbicki Z, et al. Health-related quality of life after the surgical treatment of obesity. J Physiol Pharmacol. 2005;56(6):127–34.
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.
Miner M, Esposito K, Guay A, et al. Cardiometabolic risk and female sexual health: the Princeton III summary. J Sex Med. 2012;9:641–51.
Goitein D, Zendel A, Segev L, et al. Bariatric surgery improves sexual function in obese patients. Isr Med Assoc J. 2015;17(10):616–9.
Camps MA, Zervos E, Goode S, et al. Impact of bariatric surgery on body image perception and sexuality in morbidly obese patients and their partners. Obes Surg. 1996;6:356–60.
Kolotkin RL, Binks M, Crosby RD, et al. Improvements in sexual quality of life after moderate weight loss. Int J Impot Res. 2008;20:487–92.
Dziurowicz-Kozlowska A, Lisik W, Wierzbicki Z, et al. Health related quality of life after the surgical treatment of obesity. J Physiol Pharmacol. 2005;56(6):127–34.
Hrabosky JI, Masheb RM, White MA, et al. A prospective study of body dissatisfaction and concerns in extremely obese gastric bypass patients: 6- and 12-month postoperative outcomes. Obes Surg. 2006;16:1615–21.
Sarwer DB, Fabricatore AN. Psychiatric considerations of the massive weight loss patient. Clin Plast Surg. 2008;35:1–10.
Acknowledgements
We would like to thank the Director General of Health Malaysia for his permission to publish this article. We would also like to thank Dr. Khoo Say Chuan, Consultant Urologist, Department of Urology, Hospital Pulau Pinang, Dr. Jeffrey Lee Jiajian, Medical Officer, Department of Urology, Hospital Pulau Pinang, and Dr. Umasangar Ramasamy, Consultant General Surgeon, Department of Surgery, Hospital Taiping, for their support and pearls of wisdom throughout the course of this research.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Lechmiannandan, S., Panirselvam, M., Muninathan, P. et al. Resolution of Female Sexual Dysfunction (FSD) Among the Obese Multiethnic Malaysian Women Now a Reality with Bariatric Surgery: a Prospective Pilot Study in Malaysia. OBES SURG 29, 1571–1575 (2019). https://doi.org/10.1007/s11695-019-03722-w
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-019-03722-w