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 2yr 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±1.2yr. At baseline, mean weight was 333.0±7.1 lb, BMI was 46.2±0.9kg/m2, and total testosterone was 339.9±21.32ng/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 lowsexual desire correlated negatively with free and total testosterone (r=−0.273, P=0.038; and r=−0.267, P=0.042, respectively). After 2yr, the gastric bypass surgery group had a significant decrease in BMI (−16.6±1.2 vs. −0.46±0.51kg/m2) and estradiol (−8.1±2.4 vs. 1.6±1.4pg/ml) and had an increase in total testosterone (310.8±47.6 vs. 14.2±15.3ng/dl) and free testosterone (45.2±5.1 vs. −0.4±3.0pg/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 (Table 2).

Table 2: The 2-yr Change in Anthropometric, Hormonal, and Sexual Quality of Life Measures in the Gastric Bypass Surgery and Control Groups