Sexuality in Persons With Hidradenitis Suppurativa: Factors Associated With Sexual Desire and Functioning Impairment

Abstract

Hidradenitis Suppurativa (HS) is a chronic skin disease involving intimate and sensitive areas and affecting physical and mental health. We investigated the prevalence of sexual desire and functioning impairment, and their associations with quality of life, anxiety, depression, minor psychiatric disorders (MPD), and clinical features (e.g., disease severity) in 77 patients with HS who completed self-report measures and answered to questions assessing socio-demographic characteristics, lifestyle habits, and hindered sexuality due to HS. The majority of patients reported hindered sexuality, and poor sexual functioning, while showing good levels of dyadic and solitary sexual desire. No associations were found between clinical severity and sexuality measures. Multivariate analyses showed significant associations of sexual outcome measures with alcohol consumption, low Body Mass Index, family history of HS, and severe skin symptoms. Moreover, we found that the presence of negative psychological factors (i.e., MPD, anxiety, poor mental status) increased the risk of sexual impairment. These findings underline the important role of psychological and sexual aspects in HS patients and suggest that physicians should consider the effect of disease burden on patients' sexual health.

Hidradenitis Suppurativa: The Influence of Gender, the Importance of Trigger Factors and the Implications for Patient Habits

“…Sampogna et al, analyzing the impact on sexual life through question 9 of the DLQI in 3485 dermatological patients, observed that HS was the skin condition associated with the greater sexual impairment [ 130 ]. Indeed, several studies reported (i) a high incidence of sexual impairment in HS patients [ 131 , 132 , 133 ], (ii) significantly greater sexual dysfunction (meaning impairment in the physical sphere) [ 134 , 135 , 136 ] and (iii) sexual distress (meaning impairment in the psychological sphere) [ 134 , 135 , 137 ] in patients affected by HS in comparison to control subjects ( Figure 2 ). Interestingly, the evidence from available studies indicates that the disease impact on sexual functioning might vary depending on gender.…”

“…The association between impaired sexuality and disease severity is controversial. To date, the evidence does not support a correlation between disease severity and a higher risk of sexual distress or dysfunction [ 131 , 132 , 134 , 135 , 140 ]. Interestingly, while HS was not found to be associated with increased sexual impairment in previous research [ 132 ], in their cross-sectional study, Cuenca-Barrales et al observed that the presence of a stable partner was a protective factor against sexual distress in women [ 137 , 140 ].…”

“…Specifically, the most common forms of substance misuse were alcohol (47.9%), opioids (32.7%) and cannabis (29.7%) [ 168 ]. Some authors have hypothesized that HS patients might use the aforementioned substances for their analgesic effects and to cope with the emotional and psychological disease burden ( Figure 2 ) [ 131 , 168 , 169 , 173 , 174 ]. In a multicentre French study, Lesort et al found a significantly greater prevalence of cannabis use in HS patients (37%) compared to the general population (11%) and psoriasis patients (11.6%).…”

“…Abbreviation: HS, hidradenitis suppurativa. Information extracted from references [ 72 , 86 , 87 , 112 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 152 , 157 , 158 , 168 , 169 , 173 , 174 ].…”

Hidradenitis suppurativa associated telomere‐methylome dysregulations in blood

“…Its clinical heterogeneity makes every taxonomic effort extremely difficult highlighting that clinically similar phenotypes do not necessarily belong to the same genotype. 2 . Beyond the physical aspect, HS also deeply impairs the quality of life from social interaction to the sexual quality of life, 2 which in turn could potentially increase binge eating, alcoholism and opioid abuse.…”