<p>Contraception, Sexuality and Pregnancy in Women with Psoriasis: Real-Life Experience of 235 Women</p>

Abstract

Background Little is known about how women of childbearing age with psoriasis experience contraception, sexuality and pregnancies through the lens of their skin condition. Objective To evaluate the experiences and expectations in this group of patients. Materials and Methods In total, 235 women aged between 18 and 45 years old completed an online survey. We collected the characteristics of psoriasis, contraception and pregnancy history. Psoriasis severity was measured using the Simplified Psoriasis Index. Patient quality of life was assessed using the Dermatology Life Quality Index (DLQI) and the Short Form-12. Results Psoriasis was mild in 78% of cases. The mean DLQI score was 8.8, highlighting a moderate impact of psoriasis. In total, 28% of the women had no current follow-ups, while at least two distinct physicians followed 21% of these patients. In total, 31.5% of the women felt that they could discuss sexuality during their consultations. In addition, 63% of respondents had a contraceptive method, but more than half of the women reported that contraception was rarely or never discussed during the consultations. In total, 63% had at least one pregnancy, and 61.5% reported that the doctor managing their psoriasis did not discuss their pregnancy during consultations. Psoriasis worsened during pregnancy for 21% of the respondents but improved in 34%. Among women who were not pregnant, less than 15% reported that the doctor in charge of their psoriasis discussed family planning and pregnancy possibilities. Conclusion Our study shows that the management of women of childbearing age with psoriasis must be improved with respect to sexuality, contraception and pregnancy planning.

Impact of Atopic Dermatitis on Adult Women’s Lives: A Survey of 1,009 French Women

“…In the current study, 7.3% of women reported being afraid of becoming pregnant because of their eczema. This figure is similar to a recent study whereby 8% of women with psoriasis were concerned that psoriasis influenced their pregnancy plans ( 27 ). However, unlike in psoriasis, pregnancy worsens AD in 17–61% of patients, and up to 73% in women with premenstrual syndrome ( 26 , 28 , 29 ).…”

Impact of psoriatic disease on women aged 18 to 45: Results from a multinational survey across 11 European countries

“…Improvements in shared decision-making between patients and HCPs could facilitate more integrated treatment pathways for women with psoriatic disease, potentially addressing the high proportion of women in this survey who reported a low or moderate level of general support from HCPs. These results may indicate a lack of open communication between patients and HCPs, supporting the results of previous studies in psoriatic disease ( Gottlieb et al, 2019 ; Maccari et al, 2019 ; 2020 ). Improved training for HCPs focusing on facilitating discussions with patients about their treatment preferences and concerns could help alleviate some negative outcomes reported in this survey.…”

“…A high proportion of women also reported disease flares during and after pregnancy, indicating potential worsening of their condition at this time. Many women reported a low or moderate level of support from HCPs while pregnant or attempting to conceive, supporting studies in other long-term inflammatory conditions that suggested an unmet need for patient information and a low awareness of relevant treatment guidelines among HCPs treating pregnant patients ( Ackerman et al, 2015 ; Andreoli et al, 2019 ; Maccari et al, 2019 ; 2020 ; Nelson-Piercy et al, 2019 ). Commonly used guidelines, such as the 2012 European Alliance of Associations for Rheumatology guidelines for PsA treatment, often do not contain specific advice on treatment during pregnancy, and although the European Alliance of Associations for Rheumatology has separately published points to consider for the use of antirheumatic drugs before and during pregnancy, comparable guidelines for the treatment of pregnant women with dermatological diseases are lacking ( Gossec et al, 2012 ; Götestam Skorpen et al, 2016 ; Gottlieb et al, 2019 ).…”

Impact of Psoriasis and Hidradenitis Suppurativa in Pregnancy, a Systematic Review

“…Seven studies answer this question [27,28,[33][34][35][36][37]. The evolution of psoriasis during pregnancy is unpredictable and worsening is observed in all studies (Table 3).…”

“…Eight articles answer this question [22,[26][27][28][29][30][31][32]. There seems to be an increased risk of complications during pregnancy.…”