One in four women with psoriasis reported delaying motherhood

By Olivia Hart

One in four women with psoriasis has reported delaying motherhood because of concerns about passing the condition to a child. That figure anchors an interview with Doral Fredericks, PharmD, MBA, global vice president of medical affairs and outcomes research at Organon, about care for women with plaque psoriasis and atopic dermatitis (AD).

The discussion is an expert interview rather than a prospective trial. Its supporting literature, published from 2015 through 2026, includes a 2025 systematic review of pregnancy and dermatologic disorders, a 2023 scoping review of gender in psoriasis, studies of depression, anxiety and quality of life in AD and psoriasis, and papers on family planning and severe eczema in pregnancy.

The main gap remains longitudinal research on how sex, hormones, reproductive considerations and life stages interact with either disease over time.

What does this change for women receiving psoriasis or eczema care?

Fredericks said: “A few direct, empathetic questions about mood, anxiety, stress, stigma, relationships, and daily functioning can uncover concerns that skin-focused assessments may miss.”

The answer is to widen the clinical unit of assessment beyond visible lesions. Pain, persistent itch and disrupted sleep can accompany both diseases, while reproductive concerns and hormonal shifts across menstruation, pregnancy, postpartum and menopause may affect onset, severity and flare patterns.

Fredericks also cited a potentially greater psychosocial burden in women than men, including depression, fatigue, loneliness, stress and stigma. The interview supplied no pooled rates or effect sizes for those differences, so the direction of the evidence is clearer than its magnitude.

Her proposed workflow starts with documenting patterns among disease onset, flares, sleep and mental-health symptoms, then establishing clear referral pathways. Sleep deserves explicit attention because itching and other symptoms can disrupt rest, while stress and untreated disease can reinforce one another.

Care can extend to endocrinologists or gynecologists when reproductive or hormonal issues are relevant, and to a psychologist or psychiatrist when the patient already receives that care. Fredericks said such collaboration helps clinicians understand the full patient experience and build a coherent care plan.

On multidisciplinary care, Fredericks said: “Research demonstrates multidisciplinary care that combines dermatologic treatment and mental health interventions can reduce inflammation, lower stress biomarkers, and improve patient outcomes.” The interview did not identify effect sizes or trial details, so this remains a broad research claim rather than a quantified treatment estimate.

Family planning should enter the visit early, with empathy, clear information and shared decision-making, Fredericks said. Because inheritance reflects multiple factors, she advised clinicians to counsel patients, make space for their concerns, discuss available treatment options and provide the latest available information.

Some women with eczema may underuse treatment during pregnancy because they fear harm to the child. Fredericks said clinicians should surface that concern through early counseling and shared decision-making rather than leave reduced treatment use unaddressed.

Anticipatory guidance before pregnancy and during postpartum and menopausal transitions can reduce fragmented care. The aim is to address physical symptoms, emotional burden and reproductive considerations within one care plan, rather than treating each as a separate referral.

Women may traverse a long, fragmented pathway: self-treatment, primary care visits and specialist referrals, with delays in diagnosis, treatment and support. Stigma, unmet mental-health needs and treatment considerations that shift during pregnancy, postpartum and menopause add further barriers.

Fredericks's proposed response was broader access to appropriate treatment options, stronger patient education, timely referrals and care adapted to each woman's life stage and individual needs. Clinicians can take the lead on emotional well-being, which can make honest disclosure easier, while preserving room for the patient's own priorities.

Fredericks also framed the issue through Organon's corporate lens. She said skin health and women's health can be interconnected and that the company is committed to treatment options and resources for individualized care. Organon's dermatology portfolio includes 11 medicines available in more than 70 markets.

Organon also works with the National Eczema Association, National Psoriasis Foundation and Women's Dermatologic Society on education, resources and support for patients and clinicians. The 11-medicine and 70-market figures describe company reach, not comparative trial outcomes.

The forward-looking research priority is longitudinal: follow how sex, hormones, reproductive events and life stages interact with disease onset, severity, flares and treatment over time. Until those data fill the gap, the practical change is concrete: ask about mood, sleep and reproductive intentions, document patterns, and build referral pathways before a patient reaches fragmented care.