Men's Health Wednesday May 4, 2016

Erectile Dysfunction and Psoriasis - What's The Link?

Erectile dysfunction will affect 1 in 5 men at some point in their lives. It's a common problem. There are numerous reasons and now a study has added to the list by showing it could be affected by the skin condition psoriasis.

What Is Erectile Dysfunction?

It's when a man has a problem getting or maintaining an erection. The causes can be physical, such as diabetes, high blood pressure, smoking and certain medication such as beta-blockers. Psychological reasons can also play a part in erectile dysfunction like performance anxiety, lack of sexual interest or guilt. The physical reasons can often turn into psychological ones. For example, if a man worries that he won't be able to get an erection it makes it more likely that he won't.

Erectile dysfunction is more likely to affect older men with an increase in occurrences of 5-15% when a man reaches the 40-70 age range.

A good way to identify what the cause of erectile dysfunction might be is to see if you naturally have an erection in the morning. If so, the reasons are likely to be psychological rather than physical.

What Is Psoriasis?

Psoriasis is an auto-immune disease. T-cells used by the immune system usually destroy bacteria, but in psoriasis they attack healthy skin cells. This causes the body to produce new skin cells too quickly, creating them every 3-7 days instead of the healthy 3-4 weeks. This results in flaky, silvery and crusty patches of skin characterised by psoriasis.

Skin plaques as they are called are most common on the elbows, knees, scalp and back, but they can appear anywhere on the body. These plaques can itch, sting and lead to infections if you scratch them. A lack of sleep can be blamed on psoriasis too, as the skin irritation can prevent adequate dreamtime.

Approximately 2% of the UK population have psoriasis. It affects men and women equally and usually starts before the age of 35. There is a genetic link, and the condition can worsen with triggers, such as:

  • Stress
  • Injury
  • Throat infections
  • Excess alcohol

In some patients a condition called psoriatic arthritis can develop. This leads to painful or swollen joints that require pain medication, and a study has found that metabolic syndrome reached 40% prevalence in psoriasis patients but only 23% in the general population.

Psoriasis is not contagious but patients can develop anxiety and low self esteem if psoriasis has an effect on their appearance. Swimming, for example, or wearing summer clothing can be embarrassing and awkward. Children in particular can be psychologically affected by the physical marks of psoriasis.

What's the link?

It's thought men with psoriasis are more likely to have erectile dysfunction.

A study by the Guangdong Provincial Dermatology Hospital, in Guangzhou, China looked at 191 men with psoriasis and 191 healthy men. 53% of those with the skin condition reported erectile dysfunction as opposed to 40% of the healthy group. The psoriasis groups were also more likely to report severe erectile difficulties.

There are several reasons researchers believe this might be the case.

  • Psoriasis can affect the penis which causes pain during sex or sexual activities.
  • Psoriasis plaques can cause embarrassment and affect self esteem. This can reduce sexual desire and add to insecurities. When psoriasis causes depression this can lead to erectile difficulties.
  • Men with psoriasis are more likely to have poor cardiovascular health, perhaps due to a reluctance to exercise. Revealing sportswear or depression may prevent a healthy exercise regime.

What to do about it

The senior study author Dr Sunyun Ji suggests that men with psoriasis and erectile dysfunction should keep their blood pressure, cholesterol and blood sugar levels low to improve their sexual performance. They should also seek help with psychological issues and have regular screening for depression.

Any man who has problems with erectile dysfunction should seek treatment. It's common so there's no need to be embarrassed. There are plenty of options available to help including:

  • Medications such as Viagra, Cialis and Levitra.
  • Talking therapies such as counselling and cognitive behavioural therapy.
  • Starting a healthier lifestyle to reduce blood pressure, cholesterol, and quitting smoking to improve blood flow.
  • Getting medical treatments for underlying causes such as diabetes or high blood pressure to reduce the effects.

Men with psoriasis should also seek some medical support. There's no cure for psoriasis but the treatments include:

  • Topical creams: Psoriasis on the penis (or vagina) can be treated with creams that heal skin and sooth plaques.
  • Phototherapy: Ultraviolet light is shone onto exposed skin.
  • Systemic medications that are swallowed or injected in severe cases.

If your GP cannot bring psoriasis under control you can be referred to a dermatologist for specialised advice and treatments. If it's been a while since you saw your GP about psoriasis it's worth returning because new treatments have appeared in the past few years which have success in bringing skin plaques under control.

Whatever your health issue be it erectile dysfunction, psoriasis or both, seek some treatment - there's no need to suffer in silence.

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