How Psoriasis Affects Women Differently from Men

Studies have shown that psoriasis affects women’s quality of life and mental health to a greater extent than men’s.

Compared with the general population, all people with psoriasis are more likely to be diagnosed with depression. But women with psoriasis are more likely to be depressed than men living with the condition.

Researchers believe this is because women living with psoriasis are more likely to feel stigmatized, have higher treatment expectations, and have a higher disease burden, meaning that psoriasis has a greater effect on their lives.

Research suggests that women are more likely to experience side effects when taking certain medications used to treat psoriasis.

According to some research, women are more likely to experience infections after being treated with biologic medications for their psoriasis. Biologics are medications that target specific parts of the immune system, blocking reactions in the body that trigger psoriasis symptoms. Examples of biologics used to treat psoriasis include etanercept (Enbrel) and adalimumab (Humira).

Studies have also suggested that women may experience more adverse effects than men when being treated with systemic medications — medications that impact the entire immune system — though the difference in risk seems to be small.

Some psoriasis medications, like methotrexate, retinoids, apremilast, and tazarotene, aren’t safe for pregnant people because they may cause harm to the baby or increase the risk of pregnancy complications.

There’s also a lack of scientific evidence proving the safe use of many psoriasis medications in pregnant and breastfeeding people. This means that although some psoriasis medications may be safe to use during pregnancy and breastfeeding, there’s currently no evidence to prove they’re safe.

However, there are safe psoriasis medication options for pregnant and breastfeeding people. Some topical therapies, light therapy, and systemic medications like certolizumab pegol are considered safe for pregnant and breastfeeding people.

Clinical research investigating the safety of other psoriasis medications is ongoing, so pregnant and breastfeeding people with psoriasis may have more treatment options in the near future.

Psoriasis is associated with several health issues, including elevated cholesterol and triglyceride levels, obesity, and high blood sugar.

Women with psoriasis are more likely to have larger waist circumferences, obesity, and elevated levels of blood sugar and triglycerides compared to women who don’t have the condition. They’re also more likely to take diabetes and blood pressure medications.

Interestingly, the same relationship hasn’t been identified in men. A 2020 study involving 3,723 participants found that women with psoriasis had more metabolic and cardiovascular risk factors compared with women without psoriasis. However, men with psoriasis actually had a lower risk of metabolic and cardiovascular risk factors compared with men without psoriasis.

Even though women with psoriasis seem to be at a higher risk for some health issues, you can reduce your risk of a number of these conditions, including diabetes and heart disease, by following a balanced diet and healthy lifestyle.

Female sex hormones can affect psoriasis progression and severity. For example, estrogen decreases the production of tumor necrosis factor (TNF) — a substance that causes inflammation in the body — which helps decrease psoriasis symptoms.

During pregnancy, levels of estrogen and a hormone called cortisol, which reduces inflammation, increase. Researchers think that this is why about 50% of women report an improvement in their psoriasis symptoms when they’re pregnant.

However, not all women see an improvement in psoriasis symptoms when they’re pregnant. In fact, up to 25% of women may experience a worsening of their psoriasis during pregnancy. What’s more, about 50% of women with psoriasis experience flares after giving birth.

Hormone levels also fluctuate during a woman’s menstrual cycle, so some women may find their symptoms improve during certain times of the month.

Women with psoriasis might have a harder time getting pregnant compared with women without psoriasis. A 2021 study found that out of 1,000 women, the annual fertility rate of women with psoriasis was 18.9 while the annual fertility rate of women without psoriasis was 59.1.

Researchers suggest that the systemic inflammatory environment that psoriasis creates and the higher rates of conditions like metabolic syndrome, diabetes, and heart disease among women with psoriasis may negatively affect fertility.

Psoriasis can harm male fertility as well. The good news is that certain medications, like biologics, seem to improve fertility for both men and women. Some other effective ways to improve fertility include losing excess body fat, following a nutritious diet, and engaging in regular physical activities.

Psoriasis is an inflammatory autoimmune condition that impacts health negatively in a number of ways.

Although this condition affects both sexes, studies show that psoriasis has a greater impact on women’s physical and mental well-being and that women with psoriasis respond differently to psoriasis treatments than men do. Hormonal fluctuations during and after pregnancy and during the menstrual cycle can impact psoriasis severity.

Women with psoriasis also seem to be at a greater risk of having cardiometabolic risk factors compared with men with psoriasis.

Being aware of how psoriasis may impact your health differently based on your sex can help point you in the right direction when seeking treatment. Your awareness can also help you advocate for yourself when seeking medical help.