Hidradenitis Suppurativa and Sexual Dysfunction

Patients with hidradenitis suppurativa (HS) are significantly more likely to have sexual dysfunction compared with healthy control individuals, according to findings from study published in the International Journal of Dermatology.

Researchers conducted a systematic review and meta-analysis regarding the relationship between HS and sexual functioning. They searched Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, Web of Science, and the Latin American and Caribbean Health Sciences Literature database for relevant studies published through April 18, 2020.

Eligible studies were primary research, published in the English, and involved human patients. The primary outcome measures used were validated questionnaires, including the Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF), Arizona Sexual Experiences Scale (ASEX), Frankfurt Self-Concept Scale for Sexuality (FKKS SEX), and Dermatology Life Quality Index (DLQI).

A total of 9 studies were included in the quantitative meta-analyses. The I² heterogeneity statistic was 0, which indicated low heterogeneity.

For assessing sexual dysfunction, 3 studies were included in the analysis. The pooled mean FSFI score for women with HS was 20.32 (P <.001; 95% CI, 17.29, 23.36), and the pooled mean IIEF score for men with HS was 47.96 (P <.001; 95% CI, 43.82, 52.09).

The pooled mean difference in FSFI for women with HS vs women control individuals was –5.704 (P =.003; 95% CI, –9.28, –2.13; I =0). The pooled mean difference in IIEF for men with HS vs men control individuals was –18.776 (P =.001; 95% CI, –27.411, –10.142; I²=0).

Women with HS performed worse on sexual function inventories compared with men with HS (standardized mean difference [SMD] = –0.719; P =.009; 95% CI, –0.962, –0.474; I²=0).

For the analysis regarding body mass index (BMI), 5 articles were included. The SMD in BMI between patients with HS and control individuals was 4.32 (95% CI, 2.93, 5.70; I²=11%). For patients with HS, the SMD for BMI between women and men was not significant (SMD=1.57; 95% CI, –0.02, 3.16).

Women with HS had a mean FSFI score of 20.32, which indicates mild sexual impairment and meets the FSFI criterion for sexual dysfunction (score ≤26.55), researchers acknowledged. Women with HS also reported statistically significantly worse sexual functioning vs women control individuals by 5.7 points on the same scale.

The SMD in sexual functioning between women and men patients with HS (–0.72) shows that women have moderately worse sexual impairment than men, noted the study authors. When the impact of HS was assessed on each sex, the clinical difference in sexual functioning between patients with HS and control individuals was greater in men compared with women.

The researchers noted that studies with quantitative data detailing sexual function in HS are limited. Also, sexual dysfunction is usually measured by surveys, which may create an opportunity for bias. Furthermore, the included studies used different surveys to quantify sexual dysfunction, which further limits the findings of the meta-analysis.

“The results indicate that both females and males with HS experience worse sexual functioning than their sex-matched controls,” stated the investigators. “Additionally, females with HS may experience more sexual dysfunction overall than males; however, HS may have a greater negative effect on males’ sexual functioning. Clinicians should be aware that their patients with HS, especially females, may be suffering from sexual dysfunction and treat them appropriately.”

Reference

Varney P, Guo W, Brown M, et al. A systematic review and meta-analysis of sexual dysfunction in patients with hidradenitis suppurativa. Int J Dermatol. Published online July 3, 2022. doi: 10.1111/ijd.16328