Psoriasis and Sexual Dysfunction: Is there a Connection?

Psoriasis has many effects on quality of life that extend beyond day-to-day management of the skin condition. A recent study sought to determine whether patients with psoriasis have a higher risk of sexual dysfunction (SD) or erectile dysfunction (ED) compared with the healthy population, and to review the available scientific evidence regarding the associations between psoriasis and sexual and erectile dysfunction.

Authors identified 28 epidemiologic studies regarding sexual function in patients with psoriasis. The systematic review aimed to evaluate the main characteristics of the studies of psoriasis and SD or ED, including level of evidence, tools used to assess SD or ED, and prevalence and incidence of SD or ED. The study also attempted to answer the questions of whether patients with psoriasis are at higher risk for SD or ED, whether psoriasis was an independent risk factor, the clinical features that are associated with a higher risk, and whether treatment of psoriasis played a role. The included studies encompassed 52,520 cases of psoriasis.

The results showed that in all of the studies on the topic, patients with psoriasis showed a higher risk of SD compared with healthy individuals. Prevalence data showed that half of the patients with psoriasis present some degree of SD or ED. Some clinical features that were associated with psoriasis and SD were the presence of mood status disturbances (anxiety and depression), psoriatic arthritis, and genital psoriasis. Also, female sex, psoriasis severity, and increasing age were also possibly associated with a higher risk of SD. Sexual function improved with treatment of psoriasis.

The authors conclude that psoriasis does increase the risk of SD and that patients with psoriasis have physical and psychological comorbidities that are associated with a higher risk of SD. They note that because the presence of anxiety, depression, psoriatic arthritis, genital lesions, and increasing age in a patient increase risk, these factors should likewise raise the awareness of screening for sexual problems.