Global Prevalence of Sexual Dysfunction in Individuals With Atopic Dermatitis and Asthma: A Systematic Review and Meta-Analysis
Meta-analysis found sexual dysfunction in 54% of asthma patients and 19% with atopic dermatitis
Journal: Clinical and Experimental Allergy | Published: 2026-03-08 | Type: Systematic Review and Meta-Analysis | PMID:41796075Authors: Kim Suh Hyun (University of Galway); Kim Soeun, Yeo Dongjin, Hong Seohyun, Lee Yoon, Jo Yeona, Yon Dong Keon (Center for Digital Health, Kyung Hee University Medical Center); Cho Seong H (University of South Florida); Papadopoulos Nikolaos G (National and Kapodistrian University of Athens)
Funding/COI: Funded by the Institute of Information & Communications Technology Planning & Evaluation (South Korean government ICT grant, non-industry). Authors report no conflicts of interest.
Summary
This meta-analysis pooled 19 studies across 18 countries to estimate how often people with asthma or atopic dermatitis also report sexual dysfunction. It found pooled prevalence of 54.3% in asthma and 19.1% in atopic dermatitis, with rates roughly double in women compared to men in both conditions. The heterogeneity across studies was enormous (I² = 85.7% for asthma), so the headline percentages should be read as a rough signal, not a precise estimate.
Claims
Pooled prevalence of sexual dysfunction: 54.3% (95% CI 45.9–64.3) in asthma, 19.1% (95% CI 13.4–27.3) in atopic dermatitis, from 19 studies and 1,577 patients with either condition (Kim et al., 2026).
Sex disparity in asthma: 71.5% (95% CI 63.3–80.7) in women vs. 29.6% (95% CI 17.1–51.2) in men.
Sex disparity in atopic dermatitis: 53.0% (95% CI 36.4–77.1) in women vs. 16.7% (95% CI 7.3–38.2) in men.
Control-group prevalence: 9.7% (95% CI 0.6–169.6) in men and 30.1% (95% CI 18.7–48.5) in women with asthma; 2.2% (95% CI 0.16–28.8) in atopic dermatitis controls.
Regional variation in asthma: highest in Africa (90%, 95% CI 81.9–94.7), lowest in Asia (26.4%, 95% CI 12.8–54.1).
Diagnostic method mattered: studies using validated tools reported higher prevalence than those using clinical diagnosis codes.
Smoking status showed no significant association with sexual dysfunction prevalence in asthma.
Study Quality
This is a PRISMA-adherent, PROSPERO-registered meta-analysis pulling from four databases (PubMed, Embase, Scopus, Cochrane) with independent dual-reviewer screening. The underlying evidence base it pools from is thin and heterogeneous: 19 studies covering only 1,577 patients total, using a mix of validated instruments (FSFI, IIEF, ASEX), self-developed questionnaires, single quality-of-life items, and administrative diagnostic codes to define "sexual dysfunction" — a definition that shifts prevalence estimates by an order of magnitude depending on which method a study used. The authors ran random-effects models and appropriately flagged this variability with subgroup analyses, but statistical heterogeneity was extreme (I² = 85.7% for asthma overall, exceeding 90% in several subgroups per the limitations section), meaning the pooled point estimates mask wide disagreement between individual studies rather than converging on a stable number.
The control-group data is where the cracks show most clearly: the 95% CI for male asthma controls spans 0.6% to 169.6% — a mathematically impossible upper bound for a prevalence, signaling that this subgroup estimate is built on too few studies with too little data to be usable, however it made it past peer review as reported.
Red Flags
The male asthma control-group CI (0.6–169.6%) exceeds 100%, an internal inconsistency that undermines confidence in the control comparisons used to contextualize patient prevalence.
I² above 85–90% across most analyses means the pooled percentages combine studies that don't actually agree with each other.
Only 1,577 disease-group patients across 19 studies, several of them with small individual sample sizes, especially in subgroups (sex-stratified, smoking-stratified).
No standardized definition of "sexual dysfunction" — validated multidomain questionnaires, single-item quality-of-life scores, and clinical diagnostic codes were all pooled together despite yielding very different prevalence rates.
Geographic coverage skews heavily to Europe and West Asia, with limited data from East Asia, Africa, and the Americas, despite reporting continent-level comparisons (including a 90% figure from Africa based on presumably very few studies).
Two conditions with different underlying biology (a systemic airway disease and a skin disease) are analyzed together under one sexual-dysfunction framework without a clear shared mechanism being tested.
Medication use (corticosteroids, antihistamines, antidepressants for itch/anxiety — all with known effects on sexual function) was inconsistently reported and not adjusted for.
Strengths
Large geographic scope: 18 countries across five continents, PRISMA-compliant, PROSPERO-registered protocol.
Dual independent reviewers for screening and extraction, with a third reviewer resolving disagreements.
Subgroup analyses by sex, region, smoking status, and diagnostic method, rather than reporting one blended number.
Included and reported control-group data for comparison against general-population rates, rather than presenting patient prevalence in isolation.
Non-industry funding (government ICT grant) and no reported conflicts of interest.
Transparent about its own limitations, explicitly flagging high heterogeneity and sparse control data rather than burying them.
Verdict
A methodologically careful systematic review built on a genuinely thin and inconsistent evidence base — the sex disparity finding (roughly double the prevalence in women vs. men, in both conditions) is the most robust takeaway since it repeats across both diseases and datasets, but the headline 54.3% and 19.1% prevalence figures carry enormous uncertainty (I² > 85%) and rest on a control-group comparison with an internally impossible confidence interval. Useful as a hypothesis-generating signal that clinicians managing asthma and atopic dermatitis are likely underassessing sexual function, not as a precise prevalence estimate.