Destigmatizing female sexual health through dermatologic care
New research into the impact of conditions such as psoriasis, rosacea and melanoma on female sexual and reproductive health (1250 words, 6 minutes 15 seconds)
Women in Dermatology is supported by an unrestricted grant from Galderma Canada.
Good morning and welcome to the second edition of the Women in Dermatology e-newsletter from Chronicle Companies. We are delighted to have you join us. This publication will provide you with updates on new findings regarding dermatologic issues that affect women and the female dermatologists who care for them every two weeks. We welcome your feedback and opinions, so let us know if you have any comments, observations or suggestions. You can email them to us at health@chronicle.org
A significant number of Canadian women live with chronic rheumatic diseases, psoriasis and inflammatory arthritis. While these disorders generally do not affect survival, they can harm quality of life. For Canadian women living with these conditions, access to information and support during different life stages is crucial to better manage their conditions and overall health.
At the end of September 2021, the Canadian Arthritis Patient Alliance (CAPA), the Canadian Association of Psoriasis Patients (CAPP), the Canadian Psoriasis Network (CPN) and the Canadian Spondylitis Association (CSA) released findings from the Women's Sexual and Reproductive Health Survey. The results show that female-identifying individuals (women+) have varying levels of comfort discussing reproductive and sexual health with their healthcare providers, romantic partners and support networks.
Infographic - Highlights from Baring It All: Final report from a survey on reproductive and sexual health in women+ with inflammatory arthritis, rheumatic, and psoriatic diseases.
The researchers surveyed over 400 participants, exploring many topics important to women+, including contraception, sexual health, family planning, parenting, menopause and mental health. The participants also shared their experiences with accessing health benefits, including medications, and their experiences with understanding treatments related to their sexual and reproductive health.
Key Findings:
Approximately 87% of survey participants worry about the impact of their condition on their mental health, but only 16% of participants identified seeing a mental health professional regularly.
More than 60% of survey participants stated that they did not have enough information about sexual health and the impact of their condition.
Less than 45% of survey participants felt that their healthcare providers provided adequate information about the impact of their medications on their capacity to conceive.
63% of survey participants had their doctors switch their medications to safe ones to use during pregnancy or while breastfeeding.
About one-third of participants did not feel their healthcare provider provided them with useful and helpful options to deal with their pain.
Bottom line
The report ends by making a few recommendations. The first is that it is important to destigmatize reproductive and sexual health in women+ because it is part of a holistic approach to healthcare. Another recommendation is that patient education resources available to women+ must be focused on communicating effectively about sexual health needs and concerns, the impact of medications on sexual and reproductive health, and the role of mental health and wellbeing. The report also mentions that specialists should counsel patients early in the disease journey about the impact of medications and treatments on their reproductive and sexual health.
Psoriasis has a significant impact on quality of life and sexuality in most psoriatic patients, according to a prospective case-control study published in the Italian Journal of Dermatology and Venereology.
The study included 140 female patients with psoriasis: 70 with mild disease and 70 with moderate to severe disease. It also included a control group of 70 women without psoriasis. Both psoriatic patients and the control group filled out the Female Sexual Function Index (FSFI) questionnaire.
The researchers found that the prevalence of sexual dysfunctions was significantly higher in moderate to severe psoriatic patients compared to the control group. They also found that women under 46 presented lower FSFI scores than women over that age. No correlation was found between genital localization of psoriasis and worsening of sexual health. Comorbidities such as diabetes and hypertension were also significantly associated with sexual dysfunction.
A review study published in the Dermatology Online Journal found that while topical ivermectin was more effective than metronidazole for rosacea, it posed more risks during pregnancy.
The researchers also found that three pregnant women with RF were treated successfully with topical metronidazole. Finally, it was also found that azithromycin is the only oral rosacea therapy considered safe for pregnant patients with this condition. However, there is limited pregnancy-related treatment efficacy and safety data.
A review published by the International Journal of Women's Dermatology summarized the current research on the effects of hormone therapy on melanoma in women. The authors focused on studies investigating the associations between oral contraception, fertility treatments, menopausal hormone therapy (MHT), and melanoma.
According to this review, there does not appear to be a well-established association between female hormone therapy and melanoma incidence. However, because MHT practices and formulations vary significantly across countries, the effect of MHT on melanoma risk requires further investigation with multinational studies, they write.
VIDEO: Treatment of psoriasis - new small molecules
This presentation by Professor Lidia Rudnicka focuses on drugs that are under development for the treatment of psoriasis.
Psoriatic arthritis may increase the risk for premature birth and C-section
According to a study published online in the journal Arthritis & Rheumatology, the risks for premature birth and cesarean delivery are increased in pregnant women with psoriatic arthritis (PsA). These risks vary with the presence, timing, and type of antirheumatic treatment.
The researchers found that women with PsA during their pregnancies often had other comorbidities such as obesity, presentational hypertension or diabetes and were often smokers compared with women with non-PsA pregnancies. They also found that premature birth and C-section risks were increased in patients exposed to antirheumatic treatments during pregnancy, especially biologic medications.
“Filler is a beautiful thing. It’s like sculpting and brings out my artistic desires, qualities, and talents. It is augmentative, restorative, and corrective. You can fix asymmetries in the face, fine-tune a face, sharpen or straighten, fix a deflated cheek, or sculpt a jawline.”
— Michelle Henry, MD, FAAD, Dermatologic/Mohs surgeon, New York.
Looking ahead
Registration is open for the 7th annual Skin Spectrum Summit, which starts next week on Nov. 4. Readers of Skin Spectrum Weekly are encouraged to register for this event by clicking here.
The conference secretariat is pleased to confirm that the Summit has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 6.75 Group Learning credits.
Register today for the conference or find more information on the 2021 and previous Summits at SkinSpectrum.ca
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