Review: Sex-Specific Aspects In The Bariatric Treatment Of Severely Obese Women
Pia Jäger, Annina Wolicki, Johannes Spohnholz, Metin Senkal
Published 2020 · Medicine
Download PDFAnalyze on Scholarcy
This systematic literature review aims to point out sex-specific special features that are important in the bariatric treatment of women suffering from severe obesity. A systematic literature search was carried out according to Cochrane and Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines. After the literature selection, the following categories were determined: sexuality and sexual function; contraception; fertility; sex hormones and polycystic ovary syndrome; menopause and osteoporosis; pregnancy and breastfeeding; pelvic floor disorders and urinary incontinence; female-specific cancer; and metabolism, outcome, and quality of life. For each category, the current status of research is illuminated and implications for bariatric treatment are determined. A summary that includes key messages is given for each subsection. An overall result of this paper is an understanding that sex-specific risks that follow or result from bariatric surgery should be considered more in aftercare. In order to increase the evidence, further research focusing on sex-specific differences in the outcome of bariatric surgery and promising treatment approaches to female-specific diseases is needed. Nevertheless, bariatric surgery shows good potential in the treatment of sex-specific aspects for severely obese women that goes far beyond mere weight loss and reduction of metabolic risks.
This paper references
Contraceptive Use Among Adolescent Female Metabolic and Bariatric Surgery Patients
M. Michalsky (2019)
A Decade Analysis of Trends and Outcomes of Male vs Female Patients Who Underwent Bariatric Surgery.
Monica T. Young (2016)
Adiponectin, a Therapeutic Target for Obesity, Diabetes, and Endothelial Dysfunction
Arunkumar E. Achari (2017)
Chirurgie der Adipositas und metabolischer Erkrankungen; AWMF online
Chirurgische Arbeitsgemeinschaft für Adipositaschirurgie S3 Leitlinie (2019)
Pregnancy after bariatric surgery: Consensus recommendations for periconception, antenatal and postnatal care
Jill Shawe (2019)
Sexual Health in Obese Women Asking for Bariatric Surgery
Filippo Maria Nimbi (2017)
Diagnosing gestational diabetes mellitus in women following bariatric surgery: A national survey of lead diabetes midwives
Martin Whyte (2016)
Is Bariatric Surgery Protective against Breast and Endometrial Cancers for Women? (Cover story)
E. Hoel (2015)
Clinical Practice Guidelines for Childbearing Female Candidates for Bariatric Surgery, Pregnancy, and Post-partum Management After Bariatric Surgery
Cécile Ciangura (2019)
Guttmacher Institute Contraceptive Use in the United States
Assessment of contraceptive needs in women undergoing bariatric surgery.
Biftu Mengesha (2016)
Response to: Comment on "Bariatric Surgery is Associated with Reduced Risk of Breast Cancer in Both Premenopausal and Postmenopausal Women".
Heather Spencer Feigelson (2019)
Bariatrik Sleeve Gastrektomi Tekniğinin Kadin Alt Üriner Sistem Semptomlari ve Yaşam Kalitesi Üzerine Etkisi: Prospektif Bir Çalişma Effect of Bariatric Sleeve Gastrectomy Technique on Women's Lower Urinary Tract Symptoms and Quality of Life: A Prospective Study
Fatih Uruç (2016)
Changes in ovarian morphology associated with bariatric surgery among women with polycystic ovary syndrome (PCOS)
Julia Christ (2016)
Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults
Leandra Ziad A Zargar Abdul Niveen M Benjamin Cecilia Robe Abarca-Gómez Abdeen Hamid Abu-Rmeileh Acosta-Cazar (2017)
Determining changes in bone metabolism after bariatric surgery in postmenopausal women
Andrew R. Luhrs (2019)
What Is Known About the Nutritional Intake of Women during Pregnancy Following Bariatric Surgery? A Scoping Review
Kate Maslin (2019)
Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement
David Moher (2015)
Bariatric Surgery Does Not Appear to Affect Women's Breast-Milk Composition.
Goele Jans (2018)
One-year impact of bariatric surgery on serum anti-Mullerian-hormone levels in severely obese women
Clara Vincentelli (2018)
[Abdominal pain in a pregnant patient who had gastric reduction surgery: risks associated with a history of bariatric surgery].
Wouter K G Leclercq (2018)
Does Bariatric Surgery Improve Assisted Reproductive Technology Outcomes in Obese Infertile Women?
Marco Milone (2017)
Excessive Skin and Sexual Function: Relationship with Psychological Variables and Weight Regain in Women After Bariatric Surgery
Sofia Ramalho (2014)
Prevalence and Prediction of Obstructive Sleep Apnea Prior to Bariatric Surgery—Gender-Specific Performance of Four Sleep Questionnaires
Christian Michael Horvath (2018)
AURORA: bariatric surgery registration in women of reproductive age - a multicenter prospective cohort study
Goele Jans (2016)
Oral Contraceptives after Bariatric Surgery
Joël Schlatter (2017)
Changes in Sexual Function and Positions in Women With Severe Obesity After Bariatric Surgery
Claudia Fernandes de Almeida Oliveira (2019)
Sex-Specific Aspects of Bariatric Surgery in Iran Are Far from Understood.
Mohsen Afarideh (2016)
Effects of bariatric surgery on pelvic floor disorders in obese women: a meta-analysis
Wenqing Lian (2017)
Risk of Abdominal Surgery in Pregnancy Among Women Who Have Undergone Bariatric Surgery.
Andrea E Stuart (2017)
Improvement in Fertility After Bariatric Surgery in Obese Females with Polycystic Ovarian Syndrome: Based on Four Years of Experience in Two Centers in Sulaimani Governorate, Kurdistan Region/Iraq
O AhmedHiwa (2017)
Weight loss and metabolic outcomes of bariatric surgery in men versus women - A matched comparative observational cohort study.
Andrew Kennedy-Dalby (2014)
Efficacy of Oral Glucose Tolerance Testing of Pregnant Women Post Bariatric Surgery
Lisa Newlan (2018)
Bariatric surgery for women of reproductive age.
Stephen J Robson (2016)
Obesity and polycystic ovary syndrome.
Negar Naderpoor (2015)
Chapter 4: Guide to the contents of a Cochrane protocol and review. In Cochrane Handbook for Systematic Reviews of Intervention; The Cochrane Collaboration
Resolution of Female Sexual Dysfunction (FSD) Among the Obese Multiethnic Malaysian Women Now a Reality with Bariatric Surgery: a Prospective Pilot Study in Malaysia
Sivaneswaran Lechmiannandan (2019)
Management of Pregnancy in Women Who Have Undergone Bariatric Surgery
Cara D Dolin (2016)
Nutritional Status of Children from Women with Previously Bariatric Surgery
Jessica Cristina Gimenes (2017)
Careful monitoring of fetal growth and maternal nutritional status should be practiced in pregnant women with a history of bariatric surgery
Martin Neovius (2016)
Bariatric Surgery Significantly Improves the Quality of Sexual Life and Self-esteem in Morbidly Obese Women
Faredj Cherick (2019)
Role of bariatric surgery in obese women with endometrial cancer risk.
Anawin Sanguankeo (2016)
Fertility-sparing treatment for atypical endometrial hyperplasia and endometrial cancer
Maria-Eulalia Fernández-Montolí (2018)
Physiologic and psychological gender differences in bariatric surgery
Jeanne M Kochkodan (2017)
Maternal and perinatal outcomes in pregnant women with BMI >50: An international collaborative study
Stephen J McCall (2019)
Pregnancy outcomes in women with bariatric surgery as compared with morbidly obese women
Haim Arie Abenhaim (2016)
24. Contraceptive Use Among Adolescent Female Metabolic and Bariatric Surgery Patients
Marc P Michalsky (2019)
Depression and Anxiety: Lack of Associations with an Inadequate Diet in a Sample of Pregnant Women with a History of Bariatric Surgery—a Multicenter Prospective Controlled Cohort Study
Goele Jans (2017)
Primary osteoporosis in postmenopausal women
Meng-xia Ji (2015)
Prevalence of ‘obesity-associated gonadal dysfunction’ in severely obese men and women and its resolution after bariatric surgery: a systematic review and meta-analysis
Héctor F Escobar-Morreale (2017)
American Society for Metabolic and Bariatric Surgery Guidelines for bariatric surgery as part of the ASMBS Professional Resource Center
Managing women in pregnancy after bariatric surgery: The midwife as the co-ordinator of care
Alison G Power (2019)
Pregnancy After Bariatric Surgery: National Survey of Obstetrician’s Comfort, Knowledge, and Practice Patterns
Marcela C Smid (2017)
Laboratory testing for and diagnosis of nutritional deficiencies in pregnancy before and after bariatric surgery.
Meghana D. Gadgil (2014)
Prevalence of age-specific and sex-specific overweight and obesity in Ontario and Quebec, Canada: a cross-sectional study using direct measures of height and weight
Justin Thielman (2018)
Pregnancy After Bariatric Surgery: a Comparative Study of Post-Bariatric Pregnant Women Versus Non-Bariatric Obese Pregnant Women
Bruna Balestrin (2019)
Bariatric surgery in infertile women with morbid obesity: defınitive solution?
José Maria Soares Júnior (2018)
Comment on "Bariatric Surgery is Associated with Reduced Risk of Breast Cancer in Both Premenopausal and Postmenopausal Women".
Krishanth Ganesan (2019)
Endocrine implications of bariatric surgery: a review on the intersection between incretins, bone, and sex hormones
Isabel Casimiro (2019)
Barroso Junior, U. Changes in Sexual Function and Positions in Women With Severe Obesity After Bariatric Surgery
C F A De Oliveira (2018)
Protein Identifies Low-Risk Metabolically Healthy Obese Persons: The European Prospective Investigation of Cancer-Norfolk Prospective Population Study
D F Van Wijk (2016)
Improvement of voiding characteristics in morbidly obese women after bariatric surgery: A single-center study with a 1-year follow-up.
Jae Heon Kim (2017)
Healthcare provider knowledge regarding oral contraception effectiveness for women with a history of bariatric malabsorptive procedures.
Jill P. Shah (2019)
Effect of Bariatric Surgery on Urinary Incontinence in Obese Women: A Meta-analysis and Systematic Review
Jun Zhang (2018)
Changes in Sexual Functioning in Women and Men in the 5 Years After Bariatric Surgery.
Kristine J. Steffen (2019)
Maternal and neonatal outcomes in women undergoing bariatric surgery: a systematic review and meta-analysis.
Nicolas Galazis (2014)
Polycystic ovary syndrome and endometrial hyperplasia: an overview of the role of bariatric surgery in female fertility.
Vasileios Charalampakis (2016)
Bariatric Surgery Worldwide 2013
Luigi Angrisani (2015)
European Society of Contraception Statement on Contraception in Obese Women
Gabriele S. Merki-Feld (2015)
Phrynoderma and acquired acrodermatitis enteropathica in breastfeeding women after bariatric surgery.
Babak Monshi (2015)
Female infertility: which role for obesity?
Alessandra Gambineri (2019)
Plasma concentrations of etonogestrel in women using oral desogestrel before and after Roux‐en‐Y gastric bypass surgery: a pharmacokinetic study
Charlotte Ginstman (2019)
Effect of sleeve gastrectomy bariatric surgery-induced weight loss on serum AMH levels in reproductive aged women
Shilpa Bhandari (2016)
Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis
Leanne Bellamy (2009)
Management of Pregnant Women after Bariatric Surgery
Jürgen Harreiter (2018)
Supplementation Adherence and Outcomes Among Pregnant Women After Bariatric Surgery
Silvia Leite Faria (2018)
The role of anti-Müllerian hormone in female fertility and infertility - an overview.
Anna García-Alix Grynnerup (2012)
Directed preconception health programs and interventions for improving pregnancy outcomes for women who are overweight or obese.
Nicolle Opray (2015)
Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world.
Farin Kamangar (2006)
Vitamin A and β-carotene in pregnant and breastfeeding post-bariatric women in an urban population
Diana Garretto (2019)
Ined -Institut national d'études démographiques What are the most widely used contraceptive methods across the world? Available online
09: Birthweight and intrauterine growth patterns of fetuses of pregnant women post-bariatric surgery
T Maric (2017)
Bariatric Surgery: Does It Play a Role in Fertility-Preserving Treatment Among Obese Young Women With Endometrial Cancer?
Virginia Benito (2015)
Bariatric Surgery in Women: A Boon Needs Special Care During Pregnancy.
Archana Kumari (2015)
4-Year Changes in Sex Hormones, Sexual Functioning, and Psychosocial Status in Women Who Underwent Bariatric Surgery
David B Sarwer (2017)
Bariatric surgery improves female pelvic floor disorders.
T. Knepfler (2016)
The epidemiology of obesity. Metabolism
Y. C. Chooi (2019)
Metabolic and bariatric surgery offers benefits to women beyond weight loss.
Bradley J. Needleman (2015)
The effect of bariatric surgery on inflammatory markers in women with polycystic ovarian syndrome.
Firass Abiad (2018)
Sexual behaviors, risks, and sexual health outcomes for adolescent females following bariatric surgery.
Meg H. Zeller (2019)
Bariatric surgery emphasizes biological sex differences in rodent hepatic lipid handling
Bernadette E. Grayson (2017)
Long-term incidence of female-specific cancer after bariatric surgery or usual care in the Swedish Obese Subjects Study.
Åsa Anveden (2017)
Quality of Life and Urinary Incontinence Symptoms in Women Undergoing Bariatric Surgery: A Combined Case-Cohort Study.
Kalina Durigon Keller (2019)
World Health Organization (WHO) Obesity and overweight
Impact of Bariatric surgery on antimularian hormone in reproductive age women
Maha Sahab Al kabbi (2018)
Contraceptive practices and menstrual patterns in women aged 18–50 years awaiting bariatric surgery
Yitka N H Graham (2018)
Sexual Dysfunctions in Obese Women Before and After Bariatric Surgery
Dita Pichlerová (2019)
ASMBS Guidelines/Statements, Part 2 Lipids and bariatric procedures Part 2 of 2: scientific statement from the American Society for Metabolic and Bariatric Surgery (ASMBS), the National Lipid Association (NLA), and Obesity Medicine Association (OMA) 1
Harold E Bays (2016)
Maternal obesity: pregnancy complications, gestational weight gain and nutrition.
Isabelle Guelinckx (2008)
Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation
Larissa Shamseer (2015)
Regulation of ovarian function: the role of anti-Müllerian hormone.
Alexandra L L Durlinger (2002)
Guide to the Contents of a Cochrane Protocol and Review
Julian P. T. Higgins (2008)
Sex, Race, and the Quality of Life Factors Most Important to Patients’ Well-Being Among Those Seeking Bariatric Surgery
Christina C Wee (2015)
Women at extreme risk for obesity-related carcinogenesis: Baseline endometrial pathology and impact of bariatric surgery on weight, metabolic profiles and quality of life.
Susan C Modesitt (2015)
Bariatric surgery and risk of postoperative endometrial cancer: a systematic review and meta-analysis.
Sikarin Upala (2015)
Bariatric surgery and associated adverse pregnancy outcomes among obese women*
Meiling Hua Parker (2016)
Weight loss outcomes following referral of obese women with endometrial cancer and complex atypical hyperplasia to a bariatric specialist
Amelia M Jernigan (2016)
C‐Reactive Protein Identifies Low‐Risk Metabolically Healthy Obese Persons: The European Prospective Investigation of Cancer–Norfolk Prospective Population Study
Diederik F Van Wijk (2016)
Assessment of hot flushes and vaginal dryness among obese women undergoing bariatric surgery
Sharon L. Goughnour (2016)
Bariatric Surgery in Obese Women of Reproductive Age Improves Conditions That Underlie Fertility and Pregnancy Outcomes: Retrospective Cohort Study of UK National Bariatric Surgery Registry (NBSR)
Eric Edison (2016)
Sexual functioning of men and women with severe obesity before bariatric surgery.
Kristine J. Steffen (2017)
Association of obesity with pelvic floor disorders and its effect on the quality of life in women awaiting bariatric surgery
G. K. Al-Shaikh (2018)
Self-image after bariatric surgery and its relationship to gender, excess skin and health-related quality of life
Christina Biörserud (2018)
Conception rates and contraceptive use after bariatric surgery among women with infertility: Evidence from a prospective multicenter cohort study.
Marie N. Menke (2019)
Assessment of Contraceptive Counseling and Contraceptive Use in Women After Bariatric Surgery.
Michiel A Damhof (2019)
Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis.
K J Stothard (2009)
Bariatric Surgery Reduces Serum Anti-mullerian Hormone Levels in Obese Women With and Without Polycystic Ovarian Syndrome.
Francesco Chiofalo (2017)
Perioperative pregnancy interval, contraceptive counseling experiences, and contraceptive use in women undergoing bariatric surgery
Biftu M. Mengesha (2018)
This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license
OP13.09: Birthweight and intrauterine growth patterns of fetuses of pregnant women post‐bariatric surgery
Tanya Maric (2017)
The Effect of Bariatric Surgery on Urinary Incontinence in Women
Colm J O'Boyle (2015)
Gender difference in requesting abdominoplasty, after bariatric surgery: Based on five years of experience in two centers in Sulaimani Governorate, Kurdistan Region/Iraq.
Hiwa Omer Ahmed (2018)
Bariatric Surgery Improves Hyperandrogenism, Menstrual Irregularities, and Metabolic Dysfunction Among Women with Polycystic Ovary Syndrome (PCOS)
Jacob P Christ (2018)
Effects of Bariatric Surgery on Female Pelvic Floor Disorders.
Avner Leshem (2017)
Micronutrient Deficiencies in Morbidly Obese Women Prior to Bariatric Surgery
Andrés Maroto Sánchez (2015)
Health Effects of Overweight and Obesity in 195 Countries over 25 Years.
Ashkan Mohammad H. Marissa Patrick Kara Alex Laurie Ali H Afshin Forouzanfar Reitsma Sur Estep Lee Marczak M (2017)
Is bariatric surgery the answer to urinary incontinence in obese women?
Mordechai Shimonov (2017)
Vitamin K Status in Women of Childbearing Years Before or After Bariatric Surgery
Linda M Bartholomay (2019)
The long-term effects of bariatric surgery on female urinary incontinence.
Breffini Anglim (2018)
Nutritional Status, Body Composition, and Bone Health in Women After Bariatric Surgery at a University Hospital in Rio de Janeiro
Gigliane Cosendey Menegati (2015)
Female Sexual Function Before and After Bariatric Surgery: a Cross-Sectional Study and Review of Literature
Michał R. Janik (2015)
Pelvic Organ Prolapse and Urinary Incontinence in Women After Bariatric Surgery: 5-Year Follow-up
Iwona Gabriel (2018)
The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA
Nicole C. Wright (2016)
Bariatric Surgery Worldwide
Luigi Angrisani (2017)
Urinary Incontinence and Pelvic Organ Prolapse Knowledge, Care-Seeking, and Embarrassment in Women Planning Bariatric Surgery: A Cross-sectional Study
Chandhana Paka (2019)
Contraceptive use in women undergoing bariatric surgery.
Rachel Casas (2014)
Epidemiology of obesity.
Jacob C. Seidell (2005)
Obesity Collaborators Health Effects of Overweight and Obesity in 195 Countries over 25 Years
Gbd The (2015)
World Health Organization (WHO) WHO | Controlling the global obesity epidemic
World Health Organization (WHO) Family planning/Contraception
Bariatric Surgery is Associated With Reduced Risk of Breast Cancer in Both Premenopausal and Postmenopausal Women.
Heather Spencer Feigelson (2019)
Quality of Life and Urinary Incontinence Symptoms in Women Undergoing Bariatric Surgery: A Combined Case-Cohort Study.
Kalina Durigon Keller (2019)
Bariatric surgery as a means to decrease mortality in women with type I endometrial cancer - An intriguing option in a population at risk for dying of complications of metabolic syndrome.
Robert T. Neff (2015)
Bariatric Surgery in Women of Childbearing Age, Timing Between an Operation and Birth, and Associated Perinatal Complications
Brodie A. Parent (2017)
Maternal Nutritional Deficiencies and Small-for-Gestational-Age Neonates at Birth of Women Who Have Undergone Bariatric Surgery
J Hazart (2017)
The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.
Raymond C. Rosen (2000)
Determining the worldwide prevalence of obesity
John J. Reilly (2018)