Painful sex

Hello Anon

Thank you for writing.
The term you mean is Lichen Sclerosus. This is a chronic condition that causes thin, white patches of skin, usually in the genital area. Lichen sclerosus (LS) is defined as vulvar skin that appears white in color and is thinner than normal. Although it can affect any part of the body, it is more commonly found on the skin of the vulva, foreskin or around the anal area. This vulvar condition can be found in any age group but it is most commonly found in postmenopausal woman. It can cause severe symptoms. Treatment is typically warranted and without it, many women can suffer severe consequences. Sometimes the skin can return to the normal coloration and aggressive treatment may decrease risk of formation of scarring and firm fibrotic tissues.

The exact cause of lichen sclerosus is not fully understood; however, it is not an infectious disease and woman have not caught this disease from a sexual partner. Some recent evidence may link lichen sclerosus to an over active immune system. Hormone problems may also play a role. There is also emerging support that genetics may also play an important role in getting the disease. In other cases, previous scarring and injury may have played a role.

Lichen sclerosus on your vulvar area can lead to troublesome symptoms. Often woman can complain of severe burning, tenderness, itchiness, discomfort and painful intercourse, or dyspareunia. According to an article in the European Journal of Dermatology, women with a mild case may not even be symptomatic at all.

The majority is however, and the skin may appear patchy white, tear easily, and in some cases may bleed or appear ripped or torn. The skin may be waxy in texture. At the start of the disease, lichen sclerosus may appear as small irregular shaped whitish patches that are on the vulva. It can be anywhere on the vulva including the perineum and clitoris. Several areas may join together and then the skin may appear flattened and wrinkled. Some clinicians describe the crinkled and wrinkled skin as “cigarette paper-like.”

As a result of the disease, the clitoris may become completely covered and buried. The labia may shrink in size.

The vaginal opening can become smaller and painful to the slightest touch which can cause pain on insertion or painful intercourse.

There is a 3-6 percent risk of developing vulvar squamous carcinoma, so it is important for those who have been diagnosed with lichen sclerosus to have annual follow-up evaluations by a vulvar specialist. A vulvoscopy may be warranted to examine the vulvar tissues.

The Fenton procedure you mentioned is sometimes successful, are you seeing any improvement at all? There is some concern that it can make the problem worse by causing scar tissue.

Medications that can help include corticosteroids, Protopic and Elidel - have you tried any medications?

Best,
Susan