The Impact of Vulvar Lichen Sclerosus on Sexual Dysfunction

TLDR

Lichen sclerosus is a chronic vulvar inflammatory disease that frequently causes vulvar pain and reduces quality of life. This case‑control study compared sexual function in women with LS, with and without pain, to healthy and candidiasis controls to assess LS‑related sexual dysfunction. The study included 197 biopsy‑confirmed LS patients and 138 controls (95 healthy, 43 Candida) and compared self‑reported health complaints, symptoms, sexual activity frequency, and satisfaction. LS patients reported significantly less frequent sexual activity, lower rates of vaginal intercourse, and poorer sexual satisfaction, with 23.7 % reporting rarely or never satisfactory sex versus 0 % of healthy controls and 6.5 % of Candida controls.

Abstract

Lichen sclerosus (LS) is a chronic inflammatory condition that is known to arise on the vulva. Many women with LS report vulvar pain, often affecting a patient's quality of life. In this study, the sexual function of LS patients, with and without pain, was compared to control populations.A case-control study to examine the relationship between LS and sexual dysfunction was conducted. A total of 335 women presenting to the gynecology clinic were included in the study: 197 women with biopsy confirmed LS were compared to two control groups (95 asymptomatic women were "healthy" controls and 43 women had vulvovaginal candidiasis) on self-reported current health complaints, medical and surgical history and current symptoms such as pain and itching, type and frequency of sexual activity, and satisfaction with sexual activity.Women with LS reported less frequent sexual activity than healthy controls (p=0.007) and Candida controls (p=0.04). Currently sexually active women with LS were significantly less likely to report vaginal intercourse (71.6%) than healthy controls (89.0%, p=0.003) or Candida controls (100%, p=0.0003), even though similar proportions of all three groups reported that vaginal intercourse was important. Satisfaction towards the quality of current sexual activity was significantly lower among women with LS compared with both the healthy and Candida control groups. 23.7% of women with LS reported that sexual activity was rarely or never satisfactory as compared with 0% of healthy controls (p<0.0001) and 6.5% of Candida controls (p=0.03).Women with LS have less frequent sexual activity and less satisfying sexual activity when compared with controls.