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This version published online on January 27, 2009
Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2008-1598
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Submitted on July 24, 2008
Accepted on January 15, 2009

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

Ahmad Hammoud MD, MPH*, Mark Gibson MD, Steven C. Hunt PhD, Ted D. Adams PhD, Douglass T. Carrell PhD, HCLD, Ronette L. Kolotkin PhD, and A. Wayne Meikle MD

University of Utah, Division of Reproductive Endocrinology and Infertility, SLC, UT USA; University of Utah, Cardiovascular Genetics Division, Department of Internal Medicine, SLC, UT USA; Intermountain Health & Fitness Institute, Division of Cardiology at LDS Hospital, SLC, UT USA; University of Utah, Andrology and IVF laboratories, Department of Surgery (Urology) and Physiology, SLC, UT USA; Obesity and Quality of Life Consulting, Durham, NC USA; Department of Community and Family Medicine, Duke University Health System, Durham, NC USA; University of Utah, Endocrinology/Diabetes Research, Department of Medicine, University of Utah School of Medicine, SLC, UT USA; ARUP Institute for clinical and experimental pathology, SLC, UT USA

* To whom correspondence should be addressed. 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: To define the effect of Roux-En-Y gastric bypass surgery (GBS) on the reproductive hormones and sexual function in obese men.

Design: Cohort followed for two years.

Setting: Clinical research center.

Patients: 64 severely obese men (22 had gastric bypass surgery and 42 controls).

Intervention(s): Anthropometrics (weight, BMI and percent 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.

Results: The mean age was 48.9 ± 1.2 years. 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/mL). 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). After 2 years, 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 (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 following 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.
Key words: Obesity • Roux-En-Y gastric bypass surgery • hormones • estradiol • testosterone • sexual function






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