Study: Atopic Dermatitis Severely Impacts Female Patients' Sexuality, Quality of Life

Atopic dermatitis (AD) affects female patients’ sexuality, gestational desire, and quality of life (QOL), according to a study published in Acta Dermato Venereologica.¹

The researchers noted that atopic dermatitis affects up to 17% of the adult population and can lead to symptoms like itching, pain, sleep disturbance, and depression.² Therefore, it often results in severe functionality impairments across various aspects of the patient's life, including social, familial, and occupational.³

AD has also been linked to sexual dysfunction, characterized by clinically significant impairments in the ability to experience sexual pleasure or respond sexually.⁴ However, little is known about the relationship between atopic dermatitis and sexual dysfunction.¹

Similarly, atopic dermatitis impacts the reproductive health of female patients; it is the most common dermatosis during pregnancy, with many patients going undertreated due to fear of side effects.⁵ Consequently, the researchers analyzed the impact of atopic dermatitis on sexual function and reproductive health.¹

AD significantly impairs female patients' sexual function, reproductive desires, and overall QoL. | Image Credit: Antonioguillem - stock.adobe.com

To do so, they conducted a cross-sectional study from February to March 2022 by analyzing female patients recruited through online questionnaires sent by the Spanish AD Association. More specifically, they invited female patients over the age of 18 with atopic dermatitis to participate; because of the nature of the study, male patients were excluded.

From the questionnaires, the researchers collected data on sociodemographic characteristics, drinking, and smoking habits. They assessed disease severity with the Patient-Oriented SCORing AD (PO-SCORAD) tool. Similarly, the researchers used the Dermatology Life Quality Index (DLQI), Patient Oriented Eczema Measure (POEM), and World Health Organization Quality of Life (WHOQOL) to assess QOL impairment.

Additionally, they determined SD presence with the Female Sexual Function Index-6 (FSFI-6) and a numeric rating scale (NRS), where participants were asked to measure from 0 to 10 how much atopic dermatitis affects their sexual life; patients were also asked about how atopic dermatitis affects their reproductive desires. Lastly, the psychological impact of atopic dermatitis was evaluated with Hospital Anxiety and Depression Scale (HADD and HADA) questionnaires.

The study population consisted of 102 female patients with atopic dermatitis, the mean (SD) age being 30.31 (7.75) years. Of the participants, 61% were married, 33.3% drink alcohol, and 21.6% smoke.

Also, the mean (SD) PO-SCORAD and POEM scores were 55.52 (19.69) and 15.96 (6.73) respectively, showing severe disease. Similarly, the mean (SD) DLQI (18.47 [7.92]) and WHOQOL (42.98 [20.29]) scores indicated the major impact atopic dermatitis has on patients’ QOL; this was also demonstrated by the mean (SD) HADD (8.36 [4.56]) and HADA (9.49 [4.19]) scores, showing a borderline increase in anxiety and depression.

As for sexual dysfunction, 68.8% of patients said that atopic dermatitis affected their sexual lives. More specifically, the mean (SD) NRS was 5.23 (2.16) and the mean (SD) FSFI was 16.44 (8.99), revealing sexual life impairment. Consequently, the researchers identified a positive correlation between higher NRS scores for SD and PO-SCORAD (r = 0.269; P = .006), DLQI (r = 0.518; P < .01), number of affected areas (r = 0.257, P = .009), and sleep (r = 0.242, P = .014); NRS for SD was also associated with WHOQOL (r, -0.344; P < .001) and HAD (r = 0.416; P < .001).

Additionally, 51% of patients said their atopic dermatitis may influence their reproductive desire. Conversely, 32.4% of the study population already had 1 child, 42.4% of which would like to have more children. The researchers noted that most of the patients who believed that atopic dermatitis did not influence gestational desire were already married. However, only 28.9% of women overall discussed their gestational desires with their dermatologist.

The researchers acknowledged their limitations, the main one being their relatively small sample size. Therefore, there is a potential selection bias since the study population solely represents those engaged with support groups and online resources; this may exclude the elderly, those with lower socioeconomic status, or those with apprehension toward new technologies. Despite their limitations, the researchers made future treatment suggestions to dermatologists.

“…an effort needs to be made by dermatologists to be concerned and to approach patients with AD in a more holistic way, emphasizing psychological and social aspects, such as sexuality and reproductive desires,” the authors concluded.

References

1. 1. Rodríguez-Pozo JA, Montero-Vílchez T, Diaz Calvillo P, et al. The impact of atopic dermatitis on sexual function and reproductive desires in women. Acta Derm Venereol. 2024;104:adv35107. Published 2024 Jun 11. doi:10.2340/actadv.v104.35107
2. Yu SH, Silverberg JI. Association between atopic dermatitis and depression in US adults. J Invest Dermatol. 2015;135(12):3183-3186. doi:10.1038/jid.2015.337
3. Hsieh BJ, Shen D, Hsu CJ, et al. The impact of atopic dermatitis on health-related quality of life in Taiwan. J Formos Med Assoc. 2022;121(1 Pt 2):269-277. doi:10.1016/j.jfma.2021.03.024
4. Mitchell KR, Jones KG, Wellings K, et al. Estimating the prevalence of sexual function problems: the impact of morbidity criteria. J Sex Res. 2016;53(8):955-967. doi:10.1080/00224499.2015.1089214
5. Babalola O, Strober BE. Treatment of atopic dermatitis in pregnancy. Dermatol Ther. 2013;26(4):293-301. doi:10.1111/dth.12074