Analysis of the impact of AD on women’s sexual health

Although there are numerous studies on the quality of life (QoL) of patients with atopic dermatitis (AD),¹ A group of researchers recently found that there is a lack of information about the impact of AD on women’s sexual health. The subsequent study found that AD not only affects women’s quality of life, but also their sexual health and overall desire to become pregnant.²

background

AD is known to impact patients’ social, family and occupational functioning.³ and like other skin diseases, such as hidradenitis suppurativa, it is also associated with sexual dysfunction.⁴ However, the researchers noted that little is known about the exact relationship between AD and SD. In terms of reproductive health, AD is the most common dermatosis during pregnancy,⁵ However, many patients are undertreated during this time for fear of side effects.⁶

Study methods

This cross-sectional study was conducted from February to March 2022. Women with self-reported AD diagnosis were sent an online questionnaire to collect information such as: Patient-Oriented SCORing for Atopic Dermatitis (PO-SCORAD), Dermatological Quality of Life Index (DLQI), Patient-Oriented Eczema Measure (POEM) and World Health Organization Quality of Life (WHOQOL), impact of AD on sexual life measured by a numerical rating scale (NRS) (1 to 10), and the Female Sexual Function Index-6 (FSFI-6). Patients were also asked about the impact of AD on their reproductive desire, and psychological impact was measured using the Hospital Anxiety and Depression Scale (HADD and HADA) questionnaires.

Results

The researchers found that the mean age at disease onset of the participants (n = 102) was 7.38 ± 10.24 years. The mean PO-SCORAD and POEM scores were 55.52 ± 19.69 and 15.96 ± 6.73, respectively, indicating severe disease. The researchers reported that the mean DLQI score (18.47 ± 7.92) and the mean WHOQOL score (42.98 ± 20.29) indicated a major impact of AD on patients’ quality of life. They also observed a borderline increase in anxiety and depression in patients with AD by HADD scores (8.36 ± 4.56) and HADA scores (9.49 ± 4.19).

The researchers found that 68.6% of the participants admitted that AD affected their sex life. They reported the mean NRS as 5.23 ± 2.16 and the mean FSFI as 16.44 ± 8.99, which they believed revealed an impairment in sex life. The study found that women with gluteal (6.21 vs. 4.63, p=0.007) and genital (6.59 vs. 4.74, p=0.004) involvement had higher NRS scores for SD.

Overall, the researchers found that 51% (52 of 102) of women thought that their AD could affect their desire to have children. The study found that most of those who believe that AD has no effect on the desire to become pregnant were already married and that a significant impairment in the desire to become pregnant was also observed in women with gluteal disorders. Of the 102-person sample, 32.4% (33 of 102) of women already have 1 child, while 42.2% (43 of 102) of them would like to have more. Only 28.9% (11 of 38) of women reported having spoken to their dermatologist about their desire to become pregnant.

Diploma

In this study, researchers found that patients with AD have a high mean DLQI score, suggesting a strong impact on patients’ quality of life. They also reported a borderline increase in anxiety and depression in patients with AD using the HAAD and HADA scales, further confirming previous reports.^1.3 The researchers found that over 66% of women with AD suffered from SD and that SD was directly related to PO-SCORAD, number of affected areas, sleep, and buttock and genital disorders. Finally, the study found that women with buttock disorders were less likely to want to become pregnant, but suggested that further studies are needed to confirm these findings and to examine the concerns of AD patients specifically related to pregnancy.

The researchers found that controllable factors such as symptom severity and duration increase the impact of AD on quality of life. They suggested that dermatologists should approach AD patients more holistically, focusing on psychological and social aspects such as sexuality and reproductive desires.

References

1. Silverberg JI, Gelfand JM, Margolis DJ, et al. Patient burden and quality of life in atopic dermatitis in US adults: a population-based cross-sectional study. Ann Allergy Asthma Immunol. 2018;121(3):340-347. doi:10.1016/j.anai.2018.07.006
2. Rodríguez-Pozo JA, Montero-Vílchez T, Diaz Calvillo P et al. The influence of atopic dermatitis on sexual function and reproductive will in women. Acta Derm Venereol. 2024;104:adv35107. Published on 11 June 2024. doi:10.2340/actadv.v104.35107
3. Hsieh BJ, Shen D, Hsu CJ, et al. The impact of atopic dermatitis on health-related quality of life in Taiwan. J Formos Med Assoc. 2022;121(1 Pt 2):269-277. doi:10.1016/j.jfma.2021.03.024
4. Kaundinya T, Rakita U, Silverberg JI. Prevalence, predictors, and longitudinal course of sexual dysfunction in adults with atopic dermatitis. Dermatitis. 2023;34(3):233-240. doi:10.1097/DER.0000000000000938
5. Lehrhoff S, Pomeranz MK. Specific pregnancy dermatoses and their treatment. Dermatol Ther. 2013;26(4):274-284. doi:10.1111/dth.12078
6. Babalola O, Strober BE. Treatment of atopic dermatitis in pregnancy. Dermatol Ther. 2013;26(4):293-301. doi:10.1111/dth.12074