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Effect of Roux-en-Y Gastric Bypass Surgery on the Sex Steroids and Quality of Life in Obese Men

Division of Reproductive Endocrinology and Infertility (A.H., M.G.), and Cardiovascular Genetics Division, Department of Internal Medicine (S.C.H., T.D.A.), University of Utah, Salt Lake City, Utah 84132; Intermountain Health and Fitness Institute (T.D.A.), Division of Cardiology (T.D.A.) at LDS Hospital, Salt Lake City, Utah 84111; Andrology and In Vitro Fertilization Laboratories (D.T.C.), Department of Surgery (Urology) and Physiology, University of Utah, Salt Lake City, Utah 84132; Obesity and Quality of Life Consulting (R.L.K.), Durham, North Carolina 27705; Department of Community and Family Medicine (R.L.K.), Duke University Health System, Durham, North Carolina 27710; Endocrinology/Diabetes Research, Department of Medicine (A.W.M.), University of Utah School of Medicine, Salt Lake City, Utah 84132; and ARUP Institute for Clinical and Experimental Pathology (A.W.M.), Salt Lake City, Utah 84112

Address all correspondence and requests for reprints to: Ahmad O. Hammoud, M.D., M.P.H., Assistant Professor, Division of Reproductive Endocrinology and Infertility, University of Utah, Suite 2B200, 30 North 1900 East, Salt lake City, Utah 84132. E-mail: Ahmad.hammoud{at}hsc.utah.edu.

Context: The effect of bariatric surgery on the reproductive function of obese men is not entirely elucidated.

Objective: The aim of the study was to define the effect of Roux-En-Y gastric bypass surgery on the reproductive hormones and sexual function in obese men.

Design and Setting: The cohort was followed for 2 yr at a clinical research center.

Patients: Sixty-four severely obese men (22 who had gastric bypass surgery and 42 controls) participated in the study.

Intervention(s): Anthropometrics [weight, body mass index (BMI), and percentage body fat] and reproductive hormones were measured. The sexual quality of life was assessed using the Impact of Weight on the Quality Of Life-Lite questionnaire.

Main Outcome Measure(s): Reproductive hormones and sexual quality of life were measured.

Results: The mean age was 48.9 ± 1.2 yr. At baseline, mean weight was 333.0 ± 7.1 lb, BMI was 46.2 ± 0.9 kg/m², and total testosterone was 339.9 ± 21.32 ng/dl. BMI correlated positively with estradiol and negatively with total and free testosterone. Indices of dissatisfaction with sexual quality of life correlated positively with measures of obesity. Difficult sexual performance and low sexual desire correlated negatively with free and total testosterone (r = –0.273, P = 0.038; and r = –0.267, P = 0.042, respectively). After 2 yr, the gastric bypass surgery group had a significant decrease in BMI (–16.6 ± 1.2 vs. –0.46 ± 0.51 kg/m²) and estradiol (–8.1 ± 2.4 vs. 1.6 ± 1.4 pg/ml) and had an increase in total testosterone (310.8 ± 47.6 vs. 14.2 ± 15.3 ng/dl) and free testosterone (45.2 ± 5.1 vs. –0.4 ± 3.0 pg/ml). Sexual quality of life was improved after gastric bypass surgery.

Conclusion: Hormonal alterations and diminished sexual quality of life among obese men are related to degree of obesity, and both are improved after gastric bypass surgery.