Sexual impairment in patients with hidradenitis suppurativa: a systematic review

Abstract

Hidradenitis suppurativa (HS) can cause considerable impact on several aspects of quality of life. Sexuality is a central aspect of quality of life. In recent years, there has been an increase in the number of articles on HS and sexuality. To achieve our aim of synthesizing the available scientific evidence on HS and sexual health, we conducted a systematic review in February 2020. The clinical databases used included Medline and Embase. All types of epidemiological articles were included; reviews, guidelines, protocols, conference abstracts and case report articles were excluded. Eleven studies were included for review, representing 42 729 patients with HS. The most common study design was cross‐sectional with or without comparison group(s), conducted in an outpatient setting or through surveys. Prevalence of sexual dysfunction ranged between 51–62%, and in the case of erectile dysfunction, a specific kind of sexual dysfunction affecting penile erection, it ranged from between 52% and 60% of patients studied using validated questionnaires. Potential risk factors for sexual dysfunction among men and women were identified, mainly related to disease activity, symptoms and partners. Mood disorders like depression and anxiety appear to be associated with sexual dysfunction. Women were more affected by sexual distress. HS patients with sexual dysfunction had a decreased overall quality of life. With respect to treatment, surgery did not improve sexual function and there is no scientific evidence regarding medical treatments. Patients stated that they would like to treat their sexual problems with healthcare professionals. In conclusion, sexual and erectile dysfunction are common in HS patients, and negatively affect their quality of life. There are clinical factors potentially associated with this which should be identified and treated by dermatologists in the comprehensive care of HS patients. Prospective studies are needed to provide more scientific evidence on this unmet need.

Reproductive Potential and Outcomes in Patients with Hidradenitis Suppurativa: Clinical Profile and Therapeutic Implications

“…The higher number of draining tunnels in women with fulfilled reproductive desires is explained by their longer disease duration and their more severe disease. Although we did not find differences between affected areas in two groups, the involvement of the genitalia area might influence pregnancy desires, in agreement with higher psychological impact on these patients [55].…”

Vulvar hidradenitis suppurativa: Clinical cross‐sectional study of 25 patients

“…21 The most recent systematic review about HS and sexuality has observed important sexual distress (SD) in patients with HS, some factors related to SD were: female gender, the presence of active lesions in the groin and genital areas, the intensity of pain and unpleasant odour. 22 In our study, however, no differences were observed in both groups in relation to the DLQI score. This result can be explained given that it only included women, baseline Hurley score in both groups was already high and that QoL was equally affected, probably because these patients belonged to a hospital cohort with a severe disease.…”

“…Impairment of QoL was associated with anogenital involvement, early onset of HS, disease severity and activity 21 . The most recent systematic review about HS and sexuality has observed important sexual distress (SD) in patients with HS, some factors related to SD were: female gender, the presence of active lesions in the groin and genital areas, the intensity of pain and unpleasant odour 22 . In our study, however, no differences were observed in both groups in relation to the DLQI score.…”

Quality of Life in Patients with Skin Disease and Their Cohabitants

“…Moreover, HS impairs patients' mental health. It has been related to higher levels of depression, anxiety, worse quality of life, sexual dysfunction and a higher suicide risk [44][45][46][47]. HS also has consequences on social relationships and professional careers, as high rates of absenteeism and unemployment have been reported in HS patients [43].…”