Global barriers to sexual health, pregnancy, and breastfeeding in hidradenitis suppurativa

The impact of hidradenitis suppurativa (HS) on sexual health, pregnancy, and breastfeeding in female patients is understudied. To characterize the impact of HS on sexual health, barriers to breastfeeding, and barriers to accessing care for HS during breastfeeding and pregnancy. A cross-sectional survey of self-identified adult women with HS from June 13, 2021 to June 30, 2021 was performed to assess associations between demographic and clinical factors, including age, gender, race, and ethnicity, disease severity (patient global assessment), and difficulty accessing dermatologic care with the outcomes of sexual health-related quality of life, breastfeeding practices, and barriers to care. Eight hundred eight eligible female respondents resided in 5 countries. Seventy-four point three percent self-identified as White, 8.3% Black, 2.4% Asian, 5.3% Hispanic, 7.1% Mixed race, and 1.4% Native Hawaiian or other Pacific Islander. Moderate to extreme difficulties with sexual activity and desire were associated with more difficulty accessing dermatologic care and higher patient global assessment scores ( P < .01 for all). Depression and anxiety were associated with moderate to extreme difficulties with sexual activity ( P < .01). Of the participants who were previously pregnant, 15% ( n = 79/526) reported that HS interfered with breastfeeding ability. The top barrier to care was believing nothing could be done for HS during pregnancy and breastfeeding. Diagnosis and disease severity were self-reported and could not be verified. Impaired sexual health was associated with access to care limitations, increased disease activity, and comorbid depression and anxiety. Our findings underscore the need for guidance on safe HS therapies during pregnancy and breastfeeding.