Psoriasis in women with psoriatic arthritis: hormonal effects, fertility, and considerations for management at different stages of life

Abstract

Objective. This review examines skin manifestations in women with spondyloarthritis, with a particular focus on psoriatic arthritis (PsA) and associated psoriasis. Methods. A narrative review of the bibliography was conducted using the main databases (PubMed, Scopus, EMBASE). Results. The review showed that the clinical course of PsA and psoriasis in women is influenced by hormonal fluctuations that occur at different stages of life, such as menstruation, pregnancy, postpartum, and menopause. Gender differences in the epidemiology of PsA and psoriasis are discussed and attributed to biological, hormonal, and environmental differences. The role of estrogen in modulating immune responses and its impact on the severity of PsA and psoriasis are reviewed. Special emphasis is placed on the psychosocial impact of visible skin lesions on women’s quality of life and fertility problems associated with psoriasis. Treatment strategies are also taken into account, favoring personalized approaches that consider the safety of treatments during pregnancy and breastfeeding. Conclusions. The review highlights the importance of a holistic and gender-sensitive approach to the management of PsA and psoriasis in women, promoting the integration of physical treatment with support for emotional well-being.