The Impact of Hidradenitis Suppurativa on Sexual Function: A Multicentered Cross-Sectional Study

Abstract

Background: Hidradenitis suppurativa (HS) is a disease that impairs the quality of life (QoL), sexual functioning, and fertility of the patients. The relationship between disease characteristics and sexual function remains insufficiently characterized. Objective: The aim of this study is to evaluate the rate of sexual dysfunction among HS patients; and to evaluate its relationship to disease or patient characteristics. Methods: In this multi-centered cross-sectional study, patients were asked to complete a structured online questionnaire including demographics, disease characteristics, the Hidradenitis Suppurativa Self-Assessment Tool (HSSA), HS-specific Dermatology Life Quality Index (HS-DLQI), and validated sexual function instruments (International Index of Erectile Function-5 [IIEF-5] for males; Female Sexual Function Index [FSFI] for females). Results: A total of 522 HS patients were included. Higher HSSA stages correlated positively with worse HS-DLQI scores (r = 0.258, p < 0.001). Lesions in the head/neck, inframammary, gluteal, and inguinal regions were associated with greater QoL impairment. Male patients had significantly lower IIEF scores and higher erectile dysfunction (ED) prevalence compared to controls; however, HS was not an independent risk factor for ED in multivariable analysis. Female patients had significantly lower total FSFI scores than controls, particularly in arousal, orgasm, satisfaction, and pain domains, whereas lubrication remained unaffected and desire scores were higher. Limitations: Recall bias, the self-reported nature of questionnaires, and sociocultural barriers to discussing sexual health may have influenced results. Conclusion: HS significantly impairs quality of life, particularly with increasing disease severity and involvement of specific anatomical regions. HS is associated with impaired sexual function in both women and men, with a more pronounced and multifaceted impact observed in female patients. Effective pain and inflammation control may improve sexual outcomes, underscoring the importance of comprehensive, domain-specific assessment in HS management. (Figure presented.).