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

Abstract

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.

Keywords

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

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

Abstract

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.

Keywords

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

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