Psoriasis is an immune-mediated condition that can cause widespread inflammation throughout the body. As a result of this inflammation, untreated psoriasis may 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 due to 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 may affect the hormones and glands involved in reproduction and reduce male fertility. However, careful management of this condition can reduce inflammation and minimize the effect on fertility.

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

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

The study looked at testicular function in 100 males aged 18–55 years, 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)

In comparison with 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 condition, which means that it can cause inflammation throughout the body. Evidence suggests that inflammation may have a negative effect on sperm quality and, therefore, that chronic inflammation could potentially result in infertility.

A 2017 study found a significant decrease in sperm count and motility in participants with psoriasis compared with those without the condition. Ultrasound imaging displayed inflammation of the accessory sex glands in 35 out of 50 participants with psoriasis, but none of the control participants. The male accessory sex glands 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 males, moderate estradiol levels play an important part 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 indicates 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. Similarly, a 2021 study suggests an association between oxidative stress and sperm DNA damage in men with infertility.

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

According to a 2017 study, tumor necrosis factor-alpha (TNF-alpha) inhibitors and fumaric acid esters had no negative side effects on sperm quality in males with psoriasis.

A 2020 systemic review looked at the effects of immunosuppressive medications on male fertility. The review identified no major safety concerns, although the authors note the need for further evidence to make 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 potential side effects of psoriasis treatments with a doctor and ask whether any medications might affect fertility.

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

  • smoking and drinking alcohol, which can reduce sperm numbers
  • kidney failure
  • a childhood infection of mumps
  • chromosome or hormonal problems
  • an obstruction that blocks the sperm from leaving the body, which could happen due to an infection or congenital abnormality
  • varicoceles, which are swollen veins within the scrotum
  • semen not releasing from the penis, known as retrograde ejaculation, which may occur due to surgery, medications, 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 may help reduce inflammation throughout the body and minimize its impact on fertility. Other lifestyle changes that people can consider include:

  • eating a nutritious, anti-inflammatory diet
  • limiting alcohol consumption
  • quitting smoking or avoiding secondhand smoke
  • exercising regularly
  • maintaining 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. Biologics, 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 trying to conceive or during pregnancy. People may need to leave a certain amount of time between stopping a medication and conceiving to ensure that the body has time to eliminate any medications before a baby begins developing in the womb.

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

Without treatment, psoriasis may 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 medications and lifestyle changes can help reduce inflammation and may help improve fertility. As both the condition and its treatments could possibly affect male fertility, people should discuss any concerns with a doctor.

The doctor can suggest different options to reduce or prevent fertility-related side effects, and they can 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 for people to discuss their pregnancy plans with a doctor to ensure that their current medications are safe to take during pregnancy.