EFFECTS OF OBESITY DEGREES AND THE PRESENCE OF METABOLIC SYNDROME ON THE SEXUAL LIFE OF WOMEN AND MEN

Yıl 2024, Cilt: 87 Sayı: 1, 21 - 31, 29.01.2024

Bedia Fulya Çalıkoğlu , Büşra Yıldız , Cemile İdiz , Selda Çelik , Hülya Hacişahinoğulları , Serpil Salman , Ayşe Kubat Üzüm , İlhan Satman

https://doi.org/10.26650/IUITFD.1397240

Öz

Objective: This study evaluated the sexual functions of women and men with different degrees of obesity and/or metabolic syndrome (MetSend).
Material and Methods: Participants were divided into subgroups according to their degree of obesity and presence of MetSend, and their sexual functions were evaluated using the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men. The results were compared with a healthy control group.
Result: Two hundred and thirteen (213) patients (females/ males:119/94) were included. The mean age was 39.72±6.64 and 37.84±6.83 years, and the BMI was 38.34±9.77 and 38.48±10.58 kg/m2, respectively, for females and males. Metabolic syndrome was diagnosed in 61.7% of females and 67.9% of males. In women, the BMI of those with severe sexual dysfunction (SD) was higher than those with moderate SD (p>0.05), and their age was found to be older (p=0.033). Sexual satisfaction was found to be higher in those with high BMI (p<0.001). The probability of having erectile dysfunction (ED) in men with obesity and MetSend is higher than in those without (p>0.05). While SD was detected in all women (severe-SD in 83.2%, moderate-SD in 16.8%), erectile dysfuntion was found in only 15% of men. In women, SD (moderate/severe) was associated with age (OR: 1.087, 95% CI: 1.008-1.172; p=0.030) and the presence of MetSend (OR: 4.257, 95% CI: 1.291-14.038; p=0.017), however no statistically significant relation was found in men.
Conclusion: Metabolic syndrome and obesity are closely associated with sexual dysfunction in both men and women, and it worsens as the severity of obesity increases. Contrary to expectations, sexual satisfaction in women is inversely proportional to the severity of obesity. Expectations regarding sexual satisfaction in obese individuals can be expected to be lower than in individuals of normal weight because social stigma may cause obese individuals to impose restrictions on enjoying sexual interaction. The fact that all women have SD and only 15% of men have ED calls into question the reliability of participant statements. This can be explained by the fact that sexuality is a male-dominated taboo in our country and similar Eastern cultures. Therefore, new studies with similar designs and more participants are needed to eliminate uncertainties.

Anahtar Kelimeler

Obesity, metabolic syndrome, impotence, erectile dysfunction, female sexual dysfunction, sexual satisfaction

OBEZİTENİN DERECESİ VE METABOLİK SENDROM VARLIĞININ KADIN VE ERKEK CİNSEL YAŞAMINA ETKİLERİ

Öz

Amaç: Bu çalışmada farklı derecelerde obeziteli ve/veya metabolik sendrom (MetSend) tanılı kadın ve erkeklerin cinsel işlevlerinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Katılımcılar obezite derecelerine ve MetSend varlığına göre alt gruplara ayrılmış, cinsel fonsiyonları Kadın Cinsel Fonksiyonu İndeksi (FSFI) ve Uluslararası Erektil Fonksiyon Endeksi (IIEF) kullanılarak değerlendirilmiştir. Sonuçlar sağlıklı kontrol grubuyla karşılaştırılmıştır.
Bulgular: Çalışmaya 213 hasta (kadın/erkek:119/94) dahil edilmiştir. Kadın ve erkekler için sırasıyla yaş 39,72±6,64/37,84±6,83 yıl; beden kitle indeksi (BKİ) 38,34±9,77/38,48±10,58 kg/m2 saptanmıştır. Kadınların %61’ine, erkeklerin ise %67,9’una MetSend tanısı konmuştur. Kadınlarda seksüel disfonksiyonu (SD) ciddi olanların ortalama BKİ (p>0,05) ve yaşları (p=0,033) orta derecede SD bulunanlardan daha yüksek bulunmuştur. Cinsel tatmin ise yüksek BKİ'li bireylerde daha yüksek bulunmuştur (p<0,001). Obeziteli ve MetSend bulunan erkeklerde erektil disfonksiyon (ED) varlığı, bulunmayanlara göre daha yüksektir (p>0,05). Tüm kadınlarda SD tespit edilirken (%83,2’sinde kötü-SD, %16,8’inde orta-SD), erkeklerde ED %15 oranında bulunmuştur. Kadınlarda orta/kötü SD’nun yaş (OR: 1,087, 95% CI: 1,008–1,172; p=0,030) ve MetSend varlığı (OR: 4,257; %95 CI: 1,291–14,038; p=0,017) ile ilişkili olduğu gözlenirken, erkeklerde bu parametreler arasında anlamlı ilişki bulunamamıştır.
Sonuç: Metabolik sendrom ve obezite varlığı hem kadın hem de erkeklerde SD ile ilişkili olup, obezite şiddeti arttıkça SD daha da kötüleşmektedir. Kadınlarda cinsel doyum beklenenin aksine obezite şiddetiyle ters orantılıdır. Obeziteli bireylerde cinsel doyum için beklentilerin, normal kilolulardan daha düşük olması beklenebilir. Çünkü toplumsal stigmatizasyon obeziteli bireylerin cinsel ilişkiden keyif almak konusunda bazı kısıtlamalar uygulamasına neden olabilir. Kadınların tamamında SD olup erkeklerin sadece %15’inde ED saptanması katılımcı beyanlarının güvenilirliğini sorgulatmaktadır. Bu durum bizde ve benzer doğu kültürlerinde cinselliğin erkek egemen bir tabu olması ile açıklanabilir. Bu nedenle belirsizlikleri ortadan kaldırmak için benzer tasarımda ve daha fazla katılımcıyla yapılacak yeni çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

Obezite, metabolik sendrom, impotans, erektil disfonksiyon, kadın cinsel disfonksiyonu, cinsel tatmin

Kaynakça

• 1. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169-80. [CrossRef] google scholar
• 2. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care 2002;25(9):1551-6. [CrossRef] google scholar
• 3. World Obesity Federation. World Obesity Atlas 2023. https://data.worldobesity.org/publications/WOF-Obesity-Atlas-V5.pdf. Page:210. google scholar
• 4. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009;120:1640-5. [CrossRef] google scholar
• 5. Abacı A, Kılıçkap M, Göksülük H, Karaaslan D, Barçın C. Data on prevalence of metabolic syndrome in Turkey: Systematic review, meta-analysis and meta-regression of epidemiological studies on cardiovascular risk factors. Turk Kardiyol Dern Ars 2018;46(7):591-601. [CrossRef] google scholar
• 6. Schulster ML, Liang SE, Najari BB. Metabolic syndrome and sexual dysfunction. Curr Opin Urol 2017;27(5):435-40. [CrossRef] google scholar
• 7. Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med 2003;139:161-8. [CrossRef] google scholar
• 8. Trompeter SE, Bettencourt R, Barrett-Connor E. Metabolic syndrome and sexual function in postmenopausal women Am J Med 2016;129(12):1270-7.e1. [CrossRef] google scholar
• 9. Szeligowska J, Skorupska S, Welnicki M, Mamcarz A. Sexuality in women with metabolic syndrome. Folia Cardiologica 2015;10(4):251-7. [CrossRef] google scholar
• 10. Yaylali GF, Tekekoglu S, Akin F. Sexual dysfunction in obese and overweight women. Int J Impot Res 2010;22(4):220-6. [CrossRef] google scholar
• 11. Kadioglu P, Yetkin DO, Sanli O, Yalin AS, Onem K, Kadioglu A. Obesity might not be a risk factor for female sexual dysfunction. BJU Int 2010;106(9):1357-61. [CrossRef] google scholar
• 12. Erenel AS, Kilinc FN. Does obesity increase sexual dysfunction in women? Sexuality and Disability 2013;31:53-62. [CrossRef] google scholar
• 13. Erbil N. The relation between sexual function, body image, and body mass index among women. Sexuality and Disability 2013;31:63-70. [CrossRef] google scholar
• 14. Liu Y, Hu X, Xiong M, Li J, Jiang X, Wan Y, et al. Association of BMI with erectile dysfunction: a cross-sectional study of men from an andrology clinic. Front Endocrinol (Lausanne) 2023;14:1135024. [CrossRef] google scholar
• 15. Skrypnik D, Bogdanski P, Musialik K. Obesity--significant risk factor for erectile dysfunction in men. Pol Merkur Lekarski 2014;36(212):137-41. google scholar
• 16. Akkus E, Kadioglu A, Esen A, Doran S, Ergen A, Anafarta K, Hattat H. Prevalence and correlates of erectile dysfunction in Turkey: a population-based study. Eur Urol 2002;41(3):298-304. [CrossRef] google scholar
• 17. Bal K, Oder M, Sahin AS, Karatas^ CT, Demir O, Can E, et al. Prevalence of metabolic syndrome and its association with erectile dysfunction among urologic patients: metabolic backgrounds of erectile dysfunction. Urology 2007;69(2):356-60. [CrossRef] google scholar
• 18. Kupelian V, Shabsigh R, Araujo AB, O’Donnell AB, McKinlay JB. Erectile dysfunction as a predictor of the metabolic syndrome in aging men: results from the Massachusetts Male Aging Study. J Urol 2006;176(1):222-6. [CrossRef] google scholar
• 19. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. Geneva, Switzerland: World Health Organization, 2000 (WHO technical report series 894) google scholar
• 20. National Cholesterol Education Program (NCEP): Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106(25):3143-421. google scholar
• 21. Beck AT An inventory for measuring depression Arch Gen Psychiatry 1961;4:561-71 [CrossRef] google scholar
• 22. Hisli N Beck Depresyon Envanterinin üniversite öğrencileri için geçerliliği, güvenirliği Psikoloji Derg 1989;7(23):3-13 google scholar
• 23. Ware JE, Kosinski M, Bjorner JB, editors SF-36v2s Health survey: administrative guide for clinical trial investigators Lincoln, RI: QualityMetric, Inc 2008 p 6:3 google scholar
• 24. Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A Kısa form-36 (KF36)’nın Türkçe versiyonunun güvenirliliği ve geçerliliği İlaç ve Tedavi Dergisi 1999;12(2):102-6 google scholar
• 25. Rosen RC, C Brown, Heiman J, Leiblum S, Meston C, Shabsigh R, et al The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function J Sex Marital Ther 2000;26(2):191-208 [CrossRef] google scholar
• 26. Esposito K, Ciotola M, Marfella R, Di Tommaso D, Cobellis L, Giugliano D The metabolic syndrome: a cause of sexual dysfunction in women Int J Impot Res 2005;17(3):224-6 [CrossRef] google scholar
• 27. Aygin D, Eti-Aslan F Kadın cinsel işlev ölçeğinin Türkçe’ye uyarlaması Türkiye Klinikleri J Med Sci 2005;25(3):393-9 google scholar
• 28. Rosen RC, Riley A, Wagner G, Osterloh I, Kirkpatrick J, Mishra A The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction Urology 1997;49(6):822-30 [CrossRef] google scholar
• 29. Demiral Y, Ergor G, Unal B, Semin S, Akvardar Y, Kıvırcık B, et al Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population BMC Public Health 2006;6:247 [CrossRef] google scholar
• 30. Esposito K, Giugliano F, Ciotola M, De Sio M, D’Armiento M, Giugliano D Obesity and sexual dysfunction, male and female Int J Impot Res 2008;20(4):358-65 [CrossRef] google scholar
• 31. Litwin MS, Nied RJ, Dhanani N Health-Related Quality of Life in Men with Erectile Dysfunction J Gen Intern Med 1998;13(3):159-66 [CrossRef] google scholar
• 32. Adolfsson B, Elofsson S, Rössner S, Unden AL. Are sexual dissatisfaction and sexual abuse associated with obesity? A population-based. Study Obes Res 2004;12(10):1702-9. [CrossRef] google scholar
• 33. Corona G, Mannucci E, Schulman C, Petrone L, Mansani R, Cilotti A, et al. Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction. Eur Urol 2006;50(3):595-604. [CrossRef] google scholar
• 34. Salari N, Hasheminezhad R, Sedighi T, Zarei H, Shohaimi S, Mohammadi M. The global prevalence of sexual dysfunction in obese and overweight women: a systematic review and meta-analysis. BMC Womens Health 2023;23(1):375. [CrossRef] google scholar