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


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.


  1. Michalek IM, Loring B, John SM. A systematic review of worldwide epidemiology of psoriasis. J Eur Acad Dermatol Venereol. 2017;31:205–12.

    Article  CAS  PubMed  Google Scholar 

  2. Springate DA, Parisi R, Kontopantelis E, Reeves D, Griffiths CEM, Ashcroft DM. Incidence, prevalence and mortality of patients with psoriasis: a U.K. population-based cohort study. Br J Dermatol. 2017;176:650–8.

    Article  CAS  PubMed  Google Scholar 

  3. Egeberg A, Skov L, Gislason G, Thyssen J, Mallbris L. Incidence and prevalence of psoriasis in Denmark. Acta Derm Venereol. 2017;97:808–12.

    Article  PubMed  Google Scholar 

  4. Khalid JM, Gary G, Fox KM, Chau D, Maguire A, Chiou C-F. Treatment and referral patterns for psoriasis in United Kingdom primary care: a retrospective cohort study. BMC Dermatol [Internet]. 2013 Dec;13. Available from:

  5. Bell LM. Incidence of psoriasis in Rochester, Minn, 1980-1983. Arch Dermatol. 1991;127:1184.

    Article  CAS  PubMed  Google Scholar 

  6. Rapp SR, Feldman SR, Exum ML, Fleischer AB Jr, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999;41:401–7.

    Article  CAS  PubMed  Google Scholar 

  7. Kimball AB, Jacobson C, Weiss S, Vreeland MG, Wu Y. The psychosocial burden of psoriasis. Am J Clin Dermatol. 2005;6:383–92.

    Article  PubMed  Google Scholar 

  8. Basson R, Berman J, Burnett A, Derogatis L, Ferguson D, Fourcroy J, et al. Report of the international consensus development conference on female sexual dysfunction: definitions and classifications. J Urol. 2000;163:888–93.

    Article  CAS  PubMed  Google Scholar 

  9. Weiss SC, Kimball AB, Liewehr DJ, Blauvelt A, Turner ML, Emanuel EJ. Quantifying the harmful effect of psoriasis on health-related quality of life. J Am Acad Dermatol. 2002;47:512–8.

    Article  PubMed  Google Scholar 

  10. Gupta MA, Gupta AK. Psoriasis and sex: a study of moderately to severely affected patients. Int J Dermatol. 1997;36:259–62.

    Article  CAS  PubMed  Google Scholar 

  11. Ramsay B, O’Reagan M. A survey of the social and psychological effects of psoriasis. Br J Dermatol. 1988;118:195–201.

    Article  CAS  PubMed  Google Scholar 

  12. de Arruda LHF, de Moraes APF. The impact of psoriasis on quality of life. Br J Dermatol. 2001;144:33–6.

    Article  PubMed  Google Scholar 

  13. Bardazzi F, Evangelista V, Ferrara F, Odorici G, Parodi A, Conti A, et al. Does Psoriasis influence female sexual dysfunction? A multicentric Italian case-control study. Ital J Dermatol Venerol [Internet]. 2021 Sep; Available from:

  14. Meeuwis KAP, de Hullu JA, van de Nieuwenhof HP, Evers AWM, Massuger LFAG, van de Kerkhof PCM, et al. Quality of life and sexual health in patients with genital psoriasis. Br J Dermatol. 2011;164:1247–55.

    Article  CAS  PubMed  Google Scholar 

  15. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26:191–208.

    Article  CAS  PubMed  Google Scholar 

  16. Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005;31:1–20.

    Article  PubMed  Google Scholar 

  17. Critical appraisal tools [Internet]. The University of Adelaide JBI. [cited 2022 May 12]. Available from:

  18. Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Chapter 3: Systematic reviews of effectiveness. In: JBI Manual for Evidence Synthesis. JBI; 2020.

  19. Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019;10:ED000142.

    PubMed  Google Scholar 

  20. Alariny AF, Farid CI, Elweshahi HM, Abbood SS. Psychological and Sexual Consequences of Psoriasis Vulgaris on patients and Their Partners. J Sex Med. 2019;16:1900–11.

    Article  PubMed  Google Scholar 

  21. Bazid HSK, Khaled H, El-Sabagh E. Female sexual dysfunction in patients with psoriasis and vitiligo: an Egyptian pilot study. J Egypt Womenʼs Dermatol Soc. 2021;18:22.

    Article  Google Scholar 

  22. Kurizky PS, Martins GA, Carneiro JN, Gomes CM, da Mota LMH. Evaluation of the occurrence of sexual dysfunction and general quality of life in female patients with psoriasis. Bras Dermatol. 2018;93:801–6.

    Article  Google Scholar 

  23. Gündüz A, Topçuoğlu V, Usta Gündüz EB, Ergun T, Gençosmanoğlu DS, Sungur MZ. Significant effects of body image on sexual functions and satisfaction in psoriasis patients. J Sex Marital Ther. 2020;46:160–9.

    Article  PubMed  Google Scholar 

  24. Hassanin AM, Ismail NN, El Guindi A, Sowailam HA. The emotional burden of chronic skin disease dominates physical factors among women, adversely affecting quality of life and sexual function. J Psychosom Res. 2018;115:53–7.

    Article  PubMed  Google Scholar 

  25. Özçelik S, Dogan Y, Kiliç F. Anxiety, depression, and sexual dysfunction in patients with psoriasis. Turk J Anesth Reanim. 2022;16:62.

    Article  Google Scholar 

  26. Türel Ermertcan A, Temeltaş G, Deveci A, Dinç G, Güler HB, Oztürkcan S. Sexual dysfunction in patients with psoriasis. J Dermatol. 2006;33:772–8.

    Article  PubMed  Google Scholar 

  27. Molina-Leyva A, Salvador-Rodriguez L, Martinez-Lopez A, Ruiz-Carrascosa JC, Arias-Santiago S. Association between psoriasis and sexual and erectile dysfunction in epidemiologic studies: A systematic review. JAMA Dermatol 2019;155:98–106.

    Article  PubMed  Google Scholar 

  28. Zhao S, Wang J, Xie Q, Liu Y, Luo L, Zhu Z, et al. High prevalence of erectile dysfunction in men with psoriasis: evidence from a systematic review and meta-analysis. Int J Impot Res 2019;31:74–84.

    Article  PubMed  Google Scholar 

  29. Molina-Leyva A, Jiménez-Moleón JJ, Naranjo-Sintes R, Ruiz-Carrascosa JC. Sexual dysfunction in psoriasis: a systematic review. J Eur Acad Dermatol Venereol. 2015;29:649–55.

    Article  CAS  PubMed  Google Scholar 

  30. Mercan S, Altunay IK, Demir B, Akpinar A, Kayaoglu S. Sexual dysfunctions in patients with neurodermatitis and psoriasis. J Sex Marital Ther. 2008;34:160–8.

    Article  PubMed  Google Scholar 

  31. Sampogna F, Gisondi P, Tabolli S, Abeni D, IDI Multipurpose Psoriasis Research on Vital Experiences investigators. Impairment of sexual life in patients with psoriasis. Dermatology 2007;214:144–50.

    Article  PubMed  Google Scholar 

  32. Molina-Leyva A, Almodovar-Real A, Carrascosa JC-R, Molina-Leyva I, Naranjo-Sintes R, Jimenez-Moleon JJ. Distribution pattern of psoriasis, anxiety and depression as possible causes of sexual dysfunction in patients with moderate to severe psoriasis. Bras Dermatol. 2015;90:338–45.

    Article  Google Scholar 

  33. Baldwin DS. Depression and sexual dysfunction. Br Med Bull. 2001;57:81–99.

    Article  CAS  PubMed  Google Scholar 

  34. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19:210–6.

    Article  CAS  PubMed  Google Scholar 

  35. Finlay AY, Kelly SE. Psoriasis-an index of disability. Clin Exp Dermatol. 1987;12:8–11.

    Article  CAS  PubMed  Google Scholar 

  36. McKenna KE, Stern RS. The impact of psoriasis on the quality of life of patients from the 16-center PUVA follow-up cohort. J Am Acad Dermatol. 1997;36:388–94.

    Article  CAS  PubMed  Google Scholar 

  37. Meston CM, Freihart BK, Handy AB, Kilimnik CD, Rosen RC. Scoring and Interpretation of the FSFI: What can be Learned From 20 Years of use? J Sex Med. 2020;17:17–25.

    Article  PubMed  Google Scholar 

  38. Fashokun TBO, Harvie HS, Schimpf MO, Olivera CK, Epstein LB, Jean-Michel M, et al. Sexual activity and function in women with and without pelvic floor disorders. Int Urogynecol J. 2013;24:91–7.

    Article  PubMed  Google Scholar 

  39. Dennerstein L, Alexander JL, Kotz K. The menopause and sexual functioning: a review of the population-based studies. Annu Rev Sex Res. 2003;14:64–82.

    PubMed  Google Scholar 

  40. Duarte GV, Calmon H, Radel G, de Fátima Paim de Oliveira M. Psoriasis and sexual dysfunction: links, risks, and management challenges. Psoriasis (Auckl). 2018;8:93–9.

    CAS  PubMed  Google Scholar 

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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).

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