Fewer Pounds May Lead to Better Sex, Researchers Say

Women who had weight-loss surgery reported improved sexual satisfaction, study finds

Women who shed pounds after weight-loss surgery gained a more satisfying sex life, researchers report.

Two years after their procedure, known as bariatric surgery, women reported improvements in their arousal, lubrication, sexual desire and overall sexual satisfaction, according to a study published online Nov. 4 in JAMA Surgery.

Blood tests also showed that the women had increased levels of sex hormones, leading researchers to theorize that massive weight loss could improve a woman's fertility.

The women's improved sex lives probably occurred because the weight loss improved how they felt physically and emotionally, said lead author David Sarwer, a professor in the psychiatry and surgery departments of the Perelman School of Medicine at the University of Pennsylvania.

"Sexuality truly is one of those phenomena where our behavior lies at the intersection of what's happening with us physiologically and what we are experiencing psychologically," Sarwer said.

About half of all women who seek bariatric surgery are experiencing signs of sexual dysfunction, the study authors noted in background information.

The study involved 106 women with an average body mass index (BMI) of 44.5 who underwent bariatric surgery. People with a BMI of 40 or greater are considered extremely obese.

Of the patients, 85 underwent gastric bypass surgery and 21 had a gastric banding procedure.

Following the surgery, the women lost an average of 32.7 percent of their original body weight in the first year, and 33.5 percent by the end of the second year.

By the end of the first year, women also began reporting improvements in sexual enjoyment and function. They also had improved self-esteem, felt less depressed and were more comfortable with their body image.

The improvements took place even though the women had not yet achieved their target maximum weight loss, the researchers noted.

"I think this is an important nuance that shows the interaction in sexuality between the physical and the psychosocial," Sarwer said. "Are improved hormone levels creating this rapid improvement, or is it that they are feeling better about themselves? Or is it a combination of the two?"

Women who reported the poorest quality of sexual function prior to surgery saw the most dramatic improvements one year after surgery, on par with women who reported the highest quality of sexual function prior to surgery, Sarwer said.

An expert not involved with the study said that the initial findings make sense.

"This is another good study that shows bariatric surgery helps patients in a number of ways," said Dr. Jaime Ponce, president of the American Society for Metabolic and Bariatric Surgery.

"By losing weight, it allows you to balance your good sexual hormones that control the menstrual cycle," Ponce said. "It allows them to experience improved sexual function."

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Early HIV Treatment a Win-Win, Researchers Report

Providing early antiretroviral drug treatment for recently infected HIV patients and their uninfected sexual partners is a cost-effective way to help patients stay healthy and prevent transmission of HIV, a new study finds.

The study, published Oct. 31 in the New England Journal of Medicine, looked at HIV patients in India and South Africa. Some of the patients received early antiretroviral therapy while the start of treatment was delayed for other patients. HIV is the virus that causes AIDS.

During the first five years of the study, 93 percent of those who received early antiretroviral therapy survived, compared with 83 percent of those whose treatment was delayed. Life expectancy was nearly 16 years for those in the early treatment group, compared with nearly 14 years for those in the delayed treatment group.

During the first five years, the potential costs of infections -- particularly tuberculosis -- prevented by early treatment of HIV patients in South Africa outweighed the costs of antiretroviral therapy drugs, suggesting that the early treatment strategy would reduce overall costs.

This was not the case in India, where the costs of treating HIV-related infections are less. Even so, early antiretroviral therapy in India was projected to be cost-effective according to established standards, the researchers said.

They also found that across patients' lifetimes, early antiretroviral therapy was very cost-effective in both countries. While most of the benefits of early treatment were seen in the HIV-infected patients -- fewer illnesses and deaths -- there were also added health care and economic cost savings from reducing HIV transmission, according to the study.

"By demonstrating that early HIV therapy not only has long-term clinical benefits to individuals but also provides excellent economic value in both low- and middle-income countries, this study provides a critical answer to an urgent policy question," study corresponding author Dr. Rochelle Walensky, of the Massachusetts General Hospital Division of Infectious Disease, said in a hospital news release.

"HIV-infected patients live healthier lives, their partners are protected from HIV, and the investment is superb," she added.

Walensky, a professor of Medicine at Harvard Medical School, said the findings point to a need to "redouble international efforts" to provide early antiretroviral therapy to any HIV-infected person who can benefit from it.

Her colleague, Dr. Kenneth Freedberg, director of the Medical Practice Evaluation Center at Massachusetts General, agreed.

"Some people have questioned whether providing early [antiretroviral therapy] to all who need it would be feasible in resource-limited countries," he said in the news release. "We've shown that in countries like South Africa, where it actually saves money in the short-term, the answer is 'yes.' We believe that continued international public and private partnerships can make this true in other countries as well."

Freedberg said such an investment could bring about dramatic decreases in infections and illness that could save millions of lives over the next decade.

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