Men with psoriasis may be more prone to erectile dysfunction

By Lisa Rapaport

(Reuters Health) - Men with psoriasis may be more prone to erectile dysfunction than their peers without this skin disease, and their odds of sexual difficulties are even higher if they are depressed or have other health problems like diabetes or high blood pressure, a Chinese study suggests.
Researchers studied sexual function in 191 patients with psoriasis and an equal number of healthy men. They found 53 percent of the men with psoriasis reported erectile dysfunction, compared with 40 percent in the healthy control group.
Men with psoriasis were significantly more likely to report severe erectile dysfunction, while the men without the condition were much more apt to describe milder difficulties.
When men with psoriasis do develop erectile dysfunction, they may be able to improve their sexual health by keeping blood pressure, cholesterol and blood sugar levels in a healthy range and getting screening and any needed treatment for depression, said senior study author Dr. Suyun Ji of Guangdong Provincial Dermatology Hospital in Guangzhou.
“They must pay attention to their blood pressure, blood lipids, glucose level and psychological state,” Ji said by email.
Among men with psoriasis, 20 percent of those with erectile dysfunction described it as mild, while 6 percent said symptoms were severe, Ji and colleagues report in the International Journal of Impotence Research.
Absent psoriasis, 22 percent of men with erectile dysfunction said it was mild and 2 percent reported severe symptoms.
Men with more severe depression were also more apt to report severe erectile dysfunction, the study also found.
One limitation of the study is that men weren’t randomly selected to participate, and it’s possible the analysis included men who are more comfortable talking about their sexual health, the authors note. That might mean results would be different in a broader population of men.
Even so, the findings suggest that men with psoriasis should receive routine screening for sexual dysfunction as well as for depression and risk factors of cardiovascular disease like diabetes and high blood pressure, the authors conclude.
The results also add to a growing body of research linking psoriasis to erectile dysfunction, and to depression, said Dr. Alejandro Molina-Leyva, a dermatologist at Complejo Hospitalario Torrecardenas in Almeria, Spain, who wasn’t involved in the study.
Often, men with psoriasis are obese or have other cardiovascular risk factors that may restrict blood flood in the body, including in the penis, Molina-Leyva said by email. Psoriasis can also develop on the penis, contributing to pain and discomfort during sex, and these men may also have body-image problems or other psychological issues that impair sexual performance.
“The psychological impairment of the disease, including anxiety, depression, embarrassment of their body because of psoriasis plaques, stigmatization and low self-esteem reduce sexual desire and produce insecurity and lack of concentration during sexual relationships, developing erectile dysfunction,” Molina-Leyva added.
Any man who develops erectile dysfunction, regardless of whether they have psoriasis, should see a doctor, said Dr. Jon Goulding, a dermatologist at the Heart of England NHS Foundation Trust in Birmingham, U.K., who wasn’t involved in the study.
“A screen for cardiovascular risk factors (e.g. diabetes, hypertension etc.) is crucial to pick up those which could be treated, to reduce the risk of heart attack and stroke” Goulding said by email. “Patients with psoriasis already carry a higher than average risk of cardiovascular disease, so they should strictly follow standard public health advice about maintaining a healthy body weight and exercise levels, stop smoking, and reduce alcohol intake.”
One upside to screening is men can get help with problems in the bedroom if they need it, Goulding added.
“There are lots of effective treatments for erectile dysfunction if it does develop, so don’t suffer in silence,” Goulding said.

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