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Female sexual dysfunction in psoriasis: a systematic review and meta-analysis using the Female Sexual Function Index

Abstract

Psoriasis is an inflammatory skin condition that can negatively affect numerous domains for quality of life, including sexual function. We aimed to systematically compare sexual function between women with and without psoriasis through meta-analysis. Databases were searched for studies assessing sexual function in women with and without psoriasis using the Female Sexual Function Index (FSFI). Meta-analyses were conducted in R (v4.1.2) to determine: (i) the odds ratio (OR) of sexual dysfunction and (ii) the mean difference (MD) for FSFI scores and sub-scores. Eight studies (five case-control, three cross-sectional) were eligible for review, encompassing 563 women with psoriasis and 525 controls. Risk of bias for included studies was considered as low to moderate. Psoriasis was associated with greater odds of female sexual dysfunction (OR 2.67, 95% CI 1.93,3.69; p < 0.0001). Compared to controls, women with psoriasis had significantly lower mean scores for desire (p < 0.0001), arousal (p = 0.002), lubrication (p = 0.003), orgasm (p < 0.0001), satisfaction (p < 0.0001) and total scores (p < 0.0001). Mean pain scores did not significantly differ between psoriasis patients and controls (p = 0.051). We identified significantly impaired sexual function in women with psoriasis compared to controls, suggesting that routine assessment of sexual health may be beneficial. Prospective studies of larger sample size are required in order to explore the underlying mechanisms and risk factors.

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Fig. 1
Fig. 2: Forest plot for the odds ratio of female sexual dysfunction in women with psoriasis compared to healthy controls.
Fig. 3: Forest plot for the weighted mean difference between female sexual function index (FSFI) total and sub-scores for women with psoriasis compared to healthy controls.

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Category 1: (a) Conception and design: SFHS, SAM. (b) Acquisition of data: SFHS, SAM, SAS. (c) Analysis and interpretation of data: SFHS, SAM, SAS. Category 2: (a) Drafting the article. SFHS, SAM, SAS. (b) Revising it for intellectual content: SFHS, SAM. Category 3: (a) Final approval of the completed article: SFHS, SAM.

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Correspondence to Syed Fazal Hussein Shah.

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Shah, S.F.H., Merchant, S.A. & Shah, S.A. Female sexual dysfunction in psoriasis: a systematic review and meta-analysis using the Female Sexual Function Index. Int J Impot Res (2022). https://doi.org/10.1038/s41443-022-00650-9

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