Dataset Information

Women's lived experiences of sex hormones and life-related to bariatric surgery: an interpretative qualitative study.

ABSTRACT:

Objectives

The study aimed to explore the lived experiences of women with severe obesity before and after undergoing bariatric surgery with a special focus on possible effects of changed sex hormone levels.

Design

A qualitative interview study with transcribed text analysis based on Gadamer's hermeneutics.

Setting

Regional hospital and outpatient bariatric clinic in central Sweden.

Participants

Ten women (age 23-38 years) having undergone Roux-en-Y gastric bypass surgery between 2016 and 2019 were interviewed.

Results

The transcribed interviews were analysed according to Gadamer's hermeneutics. Text horizons, interpreter horizons and fact horizons were derived and formed the fusions 'Recognition of unhealthy body weight', 'Dealing with other people's opinions and society's norms', 'Life has changed in a positive way' and 'Accepting inner self and bodily changes'.

Conclusion

Women highlighted weight and body size in their responses. The study provided a deeper understanding of the situation of women living with obesity and pros and cons of having undergone bariatric surgery. Experiences of changes in sex hormones and fertility were discussed but not central to the informants. Participants emphasised the need to be prepared and properly supported in dealing with changes in life after bariatric surgery and subsequent weight loss.

SUBMITTER: Paul R

PROVIDER: S-EPMC10314659 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

Women's lived experiences of sex hormones and life-related to bariatric surgery: an interpretative qualitative study.

Paul Rebecca R Andersson Ellen E Olbers Torsten T Frisk Jessica J Berterö Carina M CM

BMJ open 20230623 6

<h4>Objectives</h4>The study aimed to explore the lived experiences of women with severe obesity before and after undergoing bariatric surgery with a special focus on possible effects of changed sex hormone levels.<h4>Design</h4>A qualitative interview study with transcribed text analysis based on Gadamer's hermeneutics.<h4>Setting</h4>Regional hospital and outpatient bariatric clinic in central Sweden.<h4>Participants</h4>Ten women (age 23-38 years) having undergone Roux-en-Y gastric bypass sur ...[more]

PMID: 37355262

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Project description:BackgroundThe relationship between obesity and impairments in male sexual functioning is well documented. Relatively few studies have investigated changes in sexual functioning and sex hormones in men who achieve significant weight loss with bariatric surgery. The objective of this study was to assess changes in sexual functioning, sex hormones, and relevant psychosocial constructs in men who underwent bariatric surgery.MethodsA prospective cohort study of 32 men from the Longitudinal Assessment of Bariatric Surgery-2 (LABS) investigation who underwent a Roux-en-Y gastric bypass (median body mass index [25th percentile, 75th percentile] 45.1 [42.0, 52.2]) and completed assessments between 2006 and 2012. Bariatric surgery was performed by a LABS-certified surgeon. Sexual functioning was assessed by the International Index of Erectile Functioning (IIEF). Hormones were assessed by blood assay. Quality of life (QoL), body image, depressive symptoms and marital adjustment were assessed by questionnaire.ResultsMen lost, on average, (95% confidence interval) 33.3% (36.1%, 30.5%) of initial weight at postoperative year 1, 33.6% (36.8%, 30.5%) at year 2, 31.0% (34.1%, 27.9%) at year 3, and 29.4% (32.7%, 26.2%) at year 4. Participants experienced significant increases in total testosterone (P<.001) and sex hormone binding globulin (SHBG) (P<.001) through postoperative year 4. Although men reported improvements in sexual functioning after surgery, these changes did not significantly differ from baseline, with the exception of overall satisfaction at postoperative year 3 (P = .008). Participants reported significant improvements in physical domains of health-related quality of life (HRQoL), all domains of weight-related QOL, and body image, but not in the mental health domains of HRQoL or relationship satisfaction.ConclusionsMen who lost approximately one third of their weight after Roux-en-Y gastric bypass experienced significant increases in total testosterone and SHBG. They did not, however, report significant improvements in sexual functioning, relationship satisfaction, or mental health domains of HRQoL. This pattern of results differs from that of women who have undergone bariatric surgery, who reported almost uniform improvements in sexual functioning and psychosocial status.

Project description:IntroductionFemale patients expect improved quality of life, including sexual health and regain of fertility after bariatric surgery. Little has been published on to the extent to which patients' expectations are met by the weight loss after surgery.AimTo explore how women perceive the effects of bariatric surgery on quality of life, focusing on sexual health and fertility.MethodsA qualitative study based on thematic analysis, supported by questionnaire data. Interviews following a semistructured guide were conducted with childless women (n = 11) aged 25-34 years recruited from a university-affiliated Swedish bariatric center. The interviews took place 18 months after surgery in the participants' homes or at the hospital and were recorded and transcribed verbatim. Data were analyzed with a thematic approach. Questionnaires were filled in at the time of the interviews and compared with preoperative data using a Wilcoxon test for paired data.Main outcome measuresParticipants described experiences related to female sexual health after bariatric surgery. The Hospital Anxiety and Depression Scale and the Female Sexual Function Index questionnaires were administered preoperatively and postoperatively.Results"A new beginning" was identified as the master theme, with 3 underlying subthemes: "Being worthy of love," "Exploring sexuality," and "Considering parenthood." The participants described a transformation into being more comfortable with themselves that affected all areas of life, including sexual life. These findings were supported by lower scores for depression, 6.5 vs 2, and improved total Female Sexual Function Index scores, median 23.3 preoperatively and 29.1 postoperatively, P = .012.ConclusionsImproved body image and enhanced self-esteem play important roles in improved sexual functioning in women after bariatric surgery. Nilsson-Condori E, Järvholm S, Thurin-Kjellberg A, et al. A New Beginning: Young Women's Experiences and Sexual Function 18 Months After Bariatric Surgery. Sex Med 2020;8:730-739.

Project description:IntroductionObesity is associated with several co-morbidities in women, including disturbed sex hormone regulation with menstrual disturbances, subfertility, hirsutism, and central fat dispersion, all with an impact on sexual function and quality of life. There are few investigations regarding women's experiences of obesity-related altered sex hormone regulation and resolution after bariatric surgery.ObjectivesThis systematic review and interpretive meta-synthesis aim to identify the current qualitative knowledge base concerning women undergoing bariatric surgery and experiences of changes after weight loss, emphasising aspects of womanliness.MethodsA systematic review and qualitative meta-synthesis was conducted to gain a deeper and broader understanding of the available knowledge about premenopausal women's experienced changes after bariatric surgery. Relevant papers were identified by systematically searching PubMed, CINAHL, Embase, PsycInfo, PsycArticles, Scopus, Cochrane Library, Web of Science and Open Grey. The quality of the included studies was assessed, and the data was interpreted and synthesised using Gadamer's hermeneutics. The review protocol was registered on PROSPERO (CRD42023394225).ResultsA total of 10 studies were considered relevant and included in the qualitative meta-synthesis. Three fusions were identified and interpreted as: "Womanliness," "A healthy and functioning body," and "Mind and Body Connection." Women experienced a return to womanliness after undergoing bariatric surgery with restored menstruation cycles, improved fertility and changed hair and fat dispersion signalling restored sex hormones. Women value a return to a healthy and functioning body that improves their experience of life and ability to take part in it. However, women experienced difficulties in adapting mentally to the drastic physical changes that occur after undergoing surgery.ConclusionsWomen that have undergone bariatric surgery report several benefits to their health and well-being, although difficulties in adapting mentally to changes in outer appearance need to be managed in order to successfully move forward with a new life after surgery.

Dataset Information

Women's lived experiences of sex hormones and life-related to bariatric surgery: an interpretative qualitative study.

Objectives

Design

Setting

Participants

Results

Conclusion

Publications

Women's lived experiences of sex hormones and life-related to bariatric surgery: an interpretative qualitative study.

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