The effect of bariatric surgery on testosterone production in men

BACKGROUND: Male hypogonadism is associated with obesity; therefore, it is of interest to evaluate the impact of bariatric surgery – one of the most effective methods for reducing adipose tissue mass on testosterone production.

AIM: Evaluation of the effect of bariatric surgery on testosterone production in men.

MATERIALS AND METHODS: A solid prospective observational single-center interventional study included men with obesity who underwent bariatric surgery at the National Medical Research Center for Endocrinology of the Ministry of Health of the Russian Federation between January 2022 and August 2024. Dynamic assessment of body weight, body mass index, and total testosterone levels was performed. Group comparisons were made using nonparametric methods. Differences were considered statistically significant at p < 0.05. The Bonferroni correction was applied for multiple comparisons.

RESULTS: A statistically significant reduction in body weight, amounting to -30.7 [-32.8; -27.2]% from baseline, was accompanied by a statistically significant increase in testosterone levels of 6.7 [4.2; 11.4] nmol/L. Hypogonadism was resolved in 56% (95% CI 31; 79) of men. Patients who achieved eugonadism had a statistically significantly higher baseline total testosterone level of 8.2 [7.3; 8.7] nmol/L compared to men with persistent hypogonadism — 5.5 [3.7; 6.5] nmol/L, p=0.005. There were no complications from bariatric surgery.

CONCLUSION: The use of bariatric surgery leads to increased testosterone production and reduced frequency of hypogonadism in men.

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