Women Share Their Experiences With Lichen Sclerosus and Sexual Pain

Vulvar surgery might alleviate sexual pain in women with lichen sclerosus (LS), but preoperative sexual counseling is important, according to a new Journal of Sexual Medicine study.

Lichen sclerosis is a skin condition that can affect the genital and anal areas of both men and women.

Common symptoms include:

In women, LS can lead to changes in vulvar anatomy. The vagina can narrow, and the epithelium – the layer of tissue that lines the vagina – can become thin and develop fissures (tears), especially during intercourse.

As a result, penetration is often painful for women with LS. A narrow vagina may not be able to accept a penis comfortably and friction from thrusting can aggravate fissures and cause them to bleed. Some women stop having intercourse altogether.


Study on Vulvar surgery

The authors recommended that healthcare providers consult with couples before a woman has vulvar surgery for LS. They explained that knowing more about a couple’s sex life, communication skills, and willingness to make adjustments is important, as is addressing other medical factors that can cause pain.

“This information and checking for contraindications mentioned earlier would be necessary to estimate whether a woman with LS with a wish for vulvar surgery would benefit from it and/or whether she would be a candidate for additional sexual counseling pre- and/or postoperatively,” they wrote.


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