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Psoriasis and Sexual Behavior in U.S. Women: An Epidemiologic Analysis Using the National Health and Nutrition Examination Survey (NHANES)


  • Funding/support: This study was not funded.

  • Financial disclosures: None reported.

  • Prior presentation: This manuscript has not been previously published and is not under consideration in any other peer-reviewed media.

April W. Armstrong, MD, MPH, Department of Dermatology, University of California Davis Health System, 3301 C Street, Suite 1400, Sacramento, CA 95816, USA. Tel: (916) 734-6085; Fax: (916) 442-5702; E-mail:


Introduction.  Although sexual behavior is an integral part of most adults' overall well-being, this aspect of psoriasis patients' quality of life is rarely explored.

Aim.  The aim of this study is to assess the relationship between psoriasis and sexual behavior in U.S. women.

Methods.  We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006. Our study focuses on responses to the dermatology and sexual behavior questionnaires of the NHANES.

Main Outcome Measures.  This study examines the association between psoriasis and sexual behavior in U.S. women with regard to sexual orientation, age of first sexual encounter, number of sexual partners, and frequency of unprotected sex.

Results.  A total of 3,462 women provided responses to their psoriasis status: 2,753 (80%) women were heterosexual and 709 (20%) were nonheterosexual. Among them, 2.7% reported a physician-given diagnosis of psoriasis. On multivariate analyses, psoriasis was not associated with differences in sexual orientation (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.62–2.01). Among nonheterosexual women, multivariate analysis revealed a lower number of lifetime female sexual partners in women with psoriasis (rate ratio [RR] 0.11, 95% CI 0.04–0.33, P = 0.001). Among heterosexual women, no significant differences existed between those with and without psoriasis in age of first sexual encounter (weighted difference −0.54 years, 95% CI −1.27 to 0.19), number of lifetime male sexual partners (RR 1.19, 95% CI 0.69–2.06), or number of lifetime male oral sex partners (RR 0.72, 95% CI 0.40–1.29). Heterosexual women with psoriasis had 1.13 times more unprotected sex (RR 1.13, 95% CI 1.02–1.24, P = 0.03) compared with those without psoriasis.

Conclusion.  Psoriasis is associated with a significantly reduced number of sexual partners in nonheterosexual women. Psoriasis may differentially impact sexual behavior based on sexual orientation in women. Armstrong AW, Follansbee MR, Harskamp CT, and Schupp CW. Psoriasis and sexual behavior in U.S. women: An epidemiologic analysis using the National Health and Nutrition Examination Survey (NHANES). J Sex Med **;**:**–**.