Bariatric surgery essentially translates to weight loss surgery and is most commonly one of two types: gastric bypass, and gastric sleeve. Surgery is typically recommended when diet and exercise haven’t been working, or when there are serious health problems due to obesity. Obesity is a disease categorized by body mass index (BMI); typically, bariatric surgeries are recommended for obesity class III (BMI 40 or over), otherwise known as extreme obesity. Otherwise, if BMI is around 35 and there are other serious weight-related problems (such as diabetes or heart problems), then bariatric surgery may be suggested.

On top of changes to weight, appearance, and lifestyle, there are also several changes that can occur with sexual functioning, both positive and negative. However, most individuals that have undergone a type of bariatric surgery express improvements in sexual functioning. In fact, a 2007 literary review quoted 44% of patients saying they experienced improved orgasms.

Women’s Sexual Health Experience Following Bariatric Surgery

Particularly, women tend to benefit more than men, experiencing less orgasmic dysfunction, and higher sexual functioning overall. According to a 2022 study on female sexual function after bariatric surgery, the procedure (regardless of method) reduced the odds of experiencing sexual dysfunction by 76% in comparison to those who tried other methods of weight loss, like diet and exercise.

Additionally, this study stated that if someone wasn’t satisfied with their sexual function immediately following surgery, it’s likely they’d feel improvements within 5 years. This study found that the improvement in sexual functioning wasn’t related to a reduction in BMI, but may actually be linked to the psychological effects of body image, feeling healthier, etc. The aforementioned 2007 literary review cited evidence that 63% of the women studied claimed they enjoyed sexual activity more following bariatric surgery.

It has also been suggested that bariatric surgery may help with fertility in women. This may be due to a reduction in risk of weight-related diseases, such as heart problems or diabetes, as well as reduction in BMI. A 2018 overview of obesity and female fertility cited that women with a BMI over 25 may have a harder time trying to conceive. They may also be at increased risk for miscarriage, gestational diabetes, hypertension, and premature labor. Obesity can cause ovulatory dysfunction and reduce egg viability. Bariatric surgery, in reducing BMI and helping regulate certain hormones, can help with improving fertility, as would any form of weight loss.

Men’s Sexual Health Experience Following Bariatric Surgery

Men may also experience positive influences on their overall sexual functioning. It’s been reported that around 40% of men seeking a bariatric surgery also report having erectile dysfunction (ED). A 2020 study suggests bariatric surgery promotes effective improvement of erectile function, sexual satisfaction, orgasmic function, sexual desire, ejaculation disorders, and more. This is likely due to the benefits of weight loss on endothelial function, which essentially means the ability of the penile tissues to promote blood flow and therefore achieve and maintain an erection.

Improvements in sexual function may also be attributed to the positive effects of weight loss on other weight-related health concerns that may disrupt sexual activity or erectile function, such as hormonal imbalance, increased resistance to insulin, physical inactivity, psychological issues, etc.

Conversely, a 2007 literary review cited that men may report ED following bariatric surgery. This may be attributed to the lack of nutrients absorbed following surgery if dietary changes aren’t followed correctly. For this same reason, men may also experience infertility relating to low sperm count or motility. Researchers have attributed this to (mainly) a lack of zinc being absorbed into the body. It may be beneficial to speak with a healthcare provider about which vitamins may be useful for improving nutrient intake.

Conclusion

Bariatric surgery can assist immensely with mitigating morbid obesity and the other health risks that come with it. Surgery may help improve sexual function and overall sexual health, especially in women, who may also experience improvements in their fertility. Men will likely experience better sexual functioning and a lowered risk of ED, however, there is a chance that a lack of nutrients after surgery may contribute to ED and even issues with fertility.

If you have recently received bariatric surgery of some sort, these may be some side effects on your sexual health. If you are considering bariatric surgery, it’s important to speak with a healthcare provider to know if it’s the right choice for you. Always speak with your healthcare provider before making drastic dietary changes or adding vitamins to your daily routine to know which options may be the best for you.

References:

• Liu, S., Cao, D., Ren, Z., Li, J., Peng, L., Zhang, Q., Cheng, B., Cheng, Z., Ai, J., Zheng, X., Liu, L., & Wei, Q. (2020). The relationships between bariatric surgery and sexual function: Current Evidence Based Medicine. BMC Urology, 20(1). https://doi.org/10.1186/s12894-020-00707-1
• Loh, H. H., Shahar, M. A., Loh, H. S., & Yee, A. (2022). Female sexual dysfunction after bariatric surgery in WOMEN WITH OBESITY: A systematic review and meta-analysis. Scandinavian Journal of Surgery, 111(1). https://doi.org/10.1177/14574969211072395
• Mayo Foundation for Medical Education and Research. (2024a, July 5). Bariatric surgery. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258
• Merhi, Z. O. (2007). Bariatric surgery and subsequent sexual function. Fertility and Sterility, 87(3), 710–711. https://doi.org/10.1016/j.fertnstert.2006.07.1511
• Silvestris, E., de Pergola, G., Rosania, R., & Loverro, G. (2018). Obesity as disruptor of the female fertility. Reproductive Biology and Endocrinology, 16(1). https://doi.org/10.1186/s12958-018-0336-z
• Xu, J., Wu, Q., Zhang, Y., & Pei, C. (2019). Effect of bariatric surgery on male sexual function: A meta-analysis and systematic review. Sexual Medicine, 7(3), 270–281. https://doi.org/10.1016/j.esxm.2019.06.003