Sexual function in obese infertile women 5-6 years after a preconception lifestyle intervention.

Objectives: Obese infertile women are at risk for sexual dysfunction. A preconception lifestyle intervention in these women led to short-term weight reduction, a reduction in metabolic syndrome, more natural conceptions and improved physical quality of life. Here, we study whether a preconception lifestyle intervention in obese, infertile women led to improved sexual function. Method(s): Women who participated in the Dutch 'LIFEstyle' multicentre RCT between 2009-2014 were eligible for this follow-up study. Infertile women aged 18-39 years with a BMI>=29 kg/m2 (n=577) were randomised between a six-month preconception lifestyle intervention targeting physical activity, diet and behaviour or prompt infertility care. 5-6 years later, we assessed sexual function with the McCoy Female Sexuality Questionnaire. We performed logistic and linear regression comparing the intervention to the control group, adjusting for duration of infertility, PCOS status and child wish. Result(s): The intervention group (n=84) more often had intercourse in the past 4 weeks compared to the control group (n=93) (OR 2.3; CI 1.0-5.7). Within the intercourse reporting women, the intervention group (n=75) had a statistically higher intercourse frequency (6.6+/-5.8 vs. 4.9+/-4.0; CI 0.1-3.4) and higher scores for sexual satisfaction (11.8+/-2.6 vs. 10.9+/-2.6; CI 0.0-1.7), vaginal lubrication (16.5+/-3.0 vs. 15.4+/-3.5; CI 0.2-2.3) and total 'sexual function' (96.5+/-14.2 vs. 91.4+/-12.8; CI 0.9-9.5) compared to the controls (n=72). Sexual interest, orgasm and partner domain scores did not differ between groups. Conclusion(s): Obese infertile women reported better long-term sexual function after participation in a six-month lifestyle intervention aimed at weight reduction prior to infertility treatment. Future studies should investigate which aspects of a lifestyle intervention determine the effect on sexual function in order to tailor lifestyle interventions to improve sexual function.