The Effect of Female Sex Hormones and Prolactin on Female Sexual Function and Their Association with Psoriasis Severity

Background: Psoriasis is a common, immune mediated chronic inflammatory skin disease, affecting individuals of all ages with prevalence rates of 0.1–5.1% have been reported worldwide causing discomfort, disfigurement and disability. Sex hormones and prolactin have been suggested to play a role in the pathogenesis of psoriasis. The effect of psoriasis on sexual health may be linked to several factors. The study aimed to assess the female sexual function in female patients with psoriasis and the role of some hormones (Estradiol, progesterone and prolactin) in female sexual dysfunction.   Methods: This study was case-control study which conducted on 30 female patients with a diagnosis of psoriasis (psoriasis group), in addition to 20 female healthy volunteers of matched age and sex as a control group.  Determining the sexual function through female sexual function index (FSFI): All studied subjects were tested for (Estradiol, progesterone and prolactin).Results: The clinical data of psoriatic group showed that most of the patients pre­sented with psoriasis vulgaris (76.7%), (40%) presented with genital involvement, PASI scores varied from (1.8 to 47.4) with a mean of (17.49±13.9). 13 patients presented with mild PASI , 6 patients with moderate PASI while 11patients presented with sever PASI score.  Comorbidities were presented in 40% of the psoriasis group (2 cases with obesity, 2 cases with hypertension, 4 cases with DM, 1 case with dyslipidemia and 3 cases with PsA) while presented in 35% of the control group.  Female sexual dysfunction was reported in (90 %) of psoriatic patients vs (65%) of control groups. The mean of FSFI was statistically lower in psoriatic group (20.42±4.21) than control group (23.76±4.85).The result of the present study showed  a significant relation between female sexual dysfunction( FSFI) and associated comorbidities Regarding assessment of serum level of Estradiol, Progesterone and Prolactin; this study revealed significantly higher level of prolactin and progesterone level in psoriatic patients than  control group. Estradiol was higher in psoriatic group with no statistically significant between both groups. Conclusion: The female sexual dysfunction was significantly high in psoriatic cases. Female sexual dysfunction was reported more in psoriatic group associated with comorbidities and in patients presented with psoriasis involvement of genital area than psoriasis group without comorbidities or genital area affection. Both prolactin and progesterone serum level were increased in psoriatic patients.