The effect of vulvar lichen sclerosus on quality of life and sexual functioning

TLDR

Lichen sclerosus is a chronic skin disorder predominantly affecting the female anogenital region. The study aimed to assess quality of life and sexual functioning in women with lichen sclerosus compared to healthy controls and to identify factors linked to sexual dysfunction. Participants completed the Dermatology Quality of Life Index, Female Sexual Function Index, and Female Sexual Distress Scale. A 58.4 % response rate (215/368) showed that women with lichen sclerosus scored significantly lower on all Female Sexual Function Index subscales and experienced greater sexual distress than 61 age‑matched controls, with the degree of quality‑of‑life impairment independently predicting sexual dysfunction.

Abstract

Lichen sclerosus (LS) is a chronic skin disorder mostly seen on the female anogenital skin. The aim of this study was to evaluate the quality of life (QoL) and sexuality in female patients with LS and to compare their scores with healthy controls. In addition, we wanted to find factors associated with impaired sexual functioning in patients with LS. Members of the Dutch LS foundation and support group were asked to fill in three questionnaires: the Dermatology Quality of Life Index, Female Sexual Function Index (FSFI) and Female Sexual Distress Scale (FSDS). 215 of 368 patients returned their questionnaire (58.4%). Their scores were compared to a control group which consisted of 61 women of similar age (p = 0.472) without a skin disorder. Of all domains of QoL, LS interfered most with sexual functioning. Patients significantly scored lower on all subscales of the FSFI (desire (p = 0.016), arousal (p < 0.001), lubrication (p < 0.001), orgasm (p < 0.001), satisfaction (p < 0.001) and pain (p < 0.001), indicating worse sexual functioning. These problems with sexual functioning brought about significant sexual distress (p < 0.001). Patients who experienced more influence on their QoL had more sexual difficulties, leading to more sexual distress independent of their age.