Sex Drive, Fertility, and Bariatric Surgery

It is a well known fact that obesity is a risk factor for female infertility, and that fertility is often seen to improve after obesity surgery. While it has been generally thought that improvements in various hormones after surgery are the reason for the improvement in fertility, a recent study suggests that it is not just about the physiology, but also the psychology.

The study, by Dr Legro and colleagues, included 29 women having gastric bypass surgery. They looked at ovulation rates before and up to 2 years after gastric bypass surgery, and they also looked at responses to a questionnaire designed to assess sexual function.

Interestingly, they found that despite half of these women reporting irregular periods before surgery, 90% were actually ovulating before surgery. While they did see some improvements in the hormonal parameters of the menstrual cycle after surgery, what was most impressive was the marked improvement in the sexual function questionnaire scores, with the biggest improvements seen in sexual desire and arousal.

It’s important to note is that the group in this study was comprised of women who were relatively healthy obese women, so the ovulation rate may have been unusually high in this group. However, the Bottom Line of the study is that improvements in sex drive and enjoyment may be a major factor in the improvement in fertility seen after gastric bypass surgery.

The most important thing to point out is that pregnancy MUST be avoided for 1-2 years after bariatric surgery (exact recommendation varies by clinic and country), due to concerns for fetal undernutrition and poor fetal growth as well as potential nutritional deficiencies. Furthermore, there are concerns that the birth control pill may not be absorbed properly after bariatric surgery, and therefore, the pill MUST NOT be relied on for contraception. Therefore, be sure to speak to your doctor about these issues before surgery, such that appropriate plans can be made to avoid pregnancy until it’s safe to proceed.