What to know about psoriasis and male fertility

Psoriasis is an immune-mediated condition that can cause widespread inflammation throughout the body. Because of this inflammation, untreated psoriasis can have a negative effect on male fertility.

Psoriasis is an autoimmune condition that affects more than 8 million people in the United States. It occurs as a result of an overactive immune system that causes inflammation in the body. It often presents with visible signs, such as thick, itchy, scaly plaques on the skin, but it can also affect other organs and tissues in the body.

This inflammation can affect the hormones and glands involved in reproduction and reduce male fertility. However, careful management of this condition can reduce inflammation and reduce the effect on fertility.

In this article, we look at the relationship between psoriasis and fertility, other factors that can affect male fertility, and ways to address any fertility concerns.

Psoriasis is a chronic condition that causes systemic inflammation. According to a 2017 study, systemic inflammation can have a negative effect on male fertility.

The study looked at testicular function in 100 men aged 18-55, 50 of whom had psoriasis. The study assessed:

  • testosterone levels
  • levels of luteinizing hormone and follicle-stimulating hormone
  • sperm count
  • sperm motility
  • levels of sex hormone binding globulin (SHBG)

Compared to the control participants, those with psoriasis had a significant decrease in both testosterone and SHBG. Low testosterone can cause low libido and poor erectile function. SHBG is a protein that controls the amount of testosterone the body can use.

Psoriasis is a systemic inflammatory conditionwhich means it can cause inflammation throughout the body. Proof suggests that inflammation may have a negative effect on sperm quality and therefore that chronic inflammation may lead to infertility.

A 2017 study found a significant decrease in sperm count and motility in participants with psoriasis compared to those without the condition. Ultrasound imaging showed inflammation of the accessory gonads in 35 of 50 participants with psoriasis, but none of the control participants. The male accessory gonads include the seminal vesicles and the prostate gland, which contribute to sperm quality and mobility.

Learn more about the male reproductive system.

The participants with psoriasis also had higher levels of estradiol, a form of estrogen. In men, moderate estradiol levels play an important role in sexual drive and function, but higher levels may have a negative effect on sexual function.

Oxidative stress refers to an imbalance of free radicals and antioxidants in the body, which can lead to chronic inflammation. Research suggests that oxidative stress can contribute to psoriasis. A 2020 study highlights that both inflammation and oxidative stress can alter sperm function and potentially reduce fertility. Likewise, a 2021 study suggests a link between oxidative stress and sperm DNA damage in men with infertility.

Psychological stress appears to be another link between the two conditions. This is a common trigger for psoriasis, and evidence shows that chronic stress can also impair sperm production and maturation.

According to s 2017 studytumor necrosis factor-alpha (TNF-alpha) inhibitors and fumaric acid esters had no negative side effects on sperm quality in men with psoriasis.

A 2020 systemic review looked at the effects of immunosuppressive medications on male fertility. The review did not identify any major safety concerns, although the authors note the need for further evidence to draw a firm conclusion.

Most psoriasis treatments, especially many of the newer ones, have not undergone rigorous testing to check their effects on male fertility. However, people can discuss the possible side effects of psoriasis treatments with a doctor and ask if any medications can affect fertility.

Various other health conditions, medications and lifestyle factors can also affect male infertility. This includes:

  • smoking and drinking alcohol, which can reduce sperm counts
  • kidney failure
  • a childhood infection from mumps
  • chromosomal or hormonal problems
  • an obstruction that prevents the sperm from leaving the body, which can happen as a result of an infection or congenital abnormality
  • varicose veins, which are swollen veins inside the scrotum
  • semen not releasing from the penis, known as retrograde ejaculation, which can occur as a result of surgery, medication or nervous system conditions
  • certain medications, which may include treatments for arthritis, cancer, depression or high blood pressure
  • immune system problems, which cause the body to create antibodies that attack sperm and disrupt normal sperm function

Managing psoriasis can help reduce inflammation throughout the body and reduce its impact on fertility. Other lifestyle changes people can consider include:

  • eat a nutritious, anti-inflammatory diet
  • limit alcohol consumption
  • stop smoking or avoid secondhand smoke
  • to exercise regularly
  • maintain a moderate weight
  • using techniques such as meditation, yoga, or mind-body practices to manage stress

Medications can also help manage psoriasis and keep the condition under control. Biological agents, such as TNF inhibitors, can help reduce systemic inflammation.

Learn more about boosting fertility.

There is currently no clear evidence to confirm whether psoriasis has a negative effect on female fertility. According to the Psoriasis and Psoriatic Arthritis Alliance, psoriasis has no effect on a person’s likelihood of becoming pregnant.

However, some psoriasis medications may not be suitable to take when you are trying to conceive or during pregnancy. People may need to leave a certain amount of time between stopping a medication and becoming pregnant to ensure that the body has time to eliminate any medication before a baby begins to develop in the womb.

People can discuss any pregnancy plans with a doctor to ensure they are taking medication that is safe during pregnancy. If not, they may ask about switching to an alternative medication.

Without treatment, psoriasis can have a negative effect on male fertility. The reason for this is that psoriasis causes systemic inflammation, which can affect multiple systems in the body. As such, systemic inflammation can affect hormone levels and sperm quality, which can lead to male fertility problems.

Managing psoriasis with medication and lifestyle changes can help reduce inflammation and can help improve fertility. Since both the condition and its treatments can potentially affect male fertility, people should discuss any concerns with a doctor.

The doctor may suggest different options to reduce or prevent fertility-related side effects, and they may perform a semen analysis.

There is no clear evidence to suggest that psoriasis will affect female fertility. However, before trying to conceive, it is advisable that people discuss their pregnancy plans with a doctor to ensure that their current medication is safe to take during pregnancy.

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