Reproductive monitoring in patients after malabsorptive surgery

Abstract

In the contemporary health panorama, disabsorptive surgeries have emerged as a valuable tool in the fight against obesity, having proven effective in promoting significant weight loss. However, by reconfiguring the gastrointestinal anatomy to limit nutrient absorption, such procedures can have notable repercussions on the reproductive system. The delicate balance that governs human reproduction, influenced by a range of systems, particularly metabolic and endocrine functions, can be impacted, with direct and indirect consequences for patients' reproductive health. Therefore, this review aims to clarify and consolidate current knowledge about the implications of dysabsorptive surgeries on reproductive health, identifying the main effects, both direct and indirect, and highlighting recommended practices for post-operative monitoring and intervention in this context. A systematic search was carried out in the PubMed, Scopus and Web of Science databases. Articles published in the last ten years were selected, in English, Portuguese and Spanish, which addressed the relationship between dysabsorptive surgeries and impacts on the reproductive system. The inclusion criteria included cohort studies, case-control studies and previous literature reviews. The articles were analysed to discern patterns, trends and gaps in the current understanding of the subject. The consolidated data points to a series of reproductive alterations following dysabsorptive surgery. Hormonal changes emerged as an area of particular interest, having direct implications for libido, sexual function, the menstrual and ovulatory cycle, and fertility and pregnancy rates. Additionally, the relevance of integrated multidisciplinary care for post-operative patients was noted, emphasising the importance of hormonal monitoring, nutritional supplementation and reproductive counselling.