Menopause May Worsen Symptoms of Psoriasis, New Study Reveals

A recent survey study conducted in South Korea indicated that menopause has a neutral to negative effect on the course of psoriasis.1

Estrogen, which sharply declines over the 30-year post-menopausal period, has been indicated in several past studies to have a protective effect on the skin. Although no direct causal relationship has been proven, research has shown an association between the use of transepidermal estrogen and an improved skin barrier function.2 Notably, psoriasis is associated with a compromised skin-barrier function.

“We conducted surveys in North America and East Asia to understand the patient-reported impact of menopause and HRT on women with an existing diagnosis of psoriasis,” wrote Bo Young Chung, MD, department of dermatology, Kangnam Sacred Heart Hospital, Hallym University, and colleagues. “Our results provide patient-centred data that may help clinicians counsel women with psoriasis as they make the menopausal transition.”1

The online survey consisted of 35 questions, gathering demographic, social history, menopausal history, and psoriasis history and severity data. Eligible participants must have been formally diagnosed with psoriasis and have gone through menopause, which was defined as having no menstrual bleeding for ≥1 year. Respondents were recruited from outpatient dermatology clinics at the University of California, San Francisco, and Hallym University Kangnam Sacred Heart Hospital in Seoul, South Korea.1

In total, 139 participants took part in the survey – 110 from the US and 29 from South Korea. The mean age at menopause onset was 46.45 in the US group and 50.10 in the South Korean group. Together, natural menopause was reported in 71.2% of respondents, surgical menopause in 22.3%, and medical menopause in 2.2%.1

In the combined group, 10.1% of women said menopause caused their psoriasis, 33.1% said it worsened the condition, 2.2% said it improved it, and 41.7% said it had no effect. Investigators noted differences between the two groups, however, such as the frequency of psoriasis causation with menopause being higher in the US group (P = .043) while no change with menopause was more common among the Korean group (P <.001).1

A collective total of 29 participants reported receiving hormone replacement therapy (HRT) – 62.1% of the combined group received estrogen only, 3.4% received progestin only, 20.7% received a combination of both, and 13.8% were unsure. Regarding HRT’s effect on psoriasis, 62.1% of the combined group reported it had no effect, 3.4% that menopause caused psoriasis, 3.4% that it had worsened psoriasis, and 13.8% that it improved psoriasis.1

After subgroup analysis, Chung and colleagues indicated that the most significant factors associated with menopause worsening psoriasis were obesity (odds ratio [OR] 2.66: 95% CI, 1.14-6.22, P = .024), alcohol consumption history (OR, 0.41, 95% CI, .19-.92, P = .030), older age (OR, 0.95, 95% CI, 0.90-0.995, P = .030), and Asian race (OR, 0.39: 95% CI, .16-.94, P = .036). However, after multivariate analysis, only alcohol consumption history remained significant (OR, 0.19: 95% CI, .06-.59, P = .004).1

“In summary, this study showed that menopause is likely to have a neutral to negative effect on psoriasis, with very few women reporting improvement of psoriasis after menopause,” Chung and colleagues wrote. “However, despite the worsening of psoriasis in some women with menopause, the large majority of women did not need to modify their psoriasis treatment plan after menopause.”1

References

1. Chung BY, Johnson C, Park JS, et al. Patient-reported Impact of Menopause and Hormone Replacement Therapy on Psoriasis. Acta Derm Venereol. 2025;105:adv42843. Published 2025 Apr 9. doi:10.2340/actadv.v105.42843

2. Kamp E, Ashraf M, Musbahi E, DeGiovanni C. Menopause, skin and common dermatoses. Part 2: skin disorders. Clin Exp Dermatol. 2022;47(12):2117-2122. doi:10.1111/ced.15308