Rates of Self-Reported Urinary, Gastrointestinal, and Pain Comorbidities in Women With Vulvar Lichen Sclerosus

Abstract

Objective-To determine the prevalences of comorbid disorders in women with vulvar lichen sclerosus. . Prevalences of self-reported comorbidities in our subjects are: OAB 15.3%, UI 38.6%, SUI 27.9%, IBD 1.9%, Constipation 32.5%, IBS 19.5%, Thyroid dysfunction 33.1%, IC 2.6%, Fibromyalgia 9.1%, TMJ 13.0%, Vulvar pain 83.1%. The prevalence of each disorder is significantly different than that in the general population, with all p values ≤ 0.02. Materials and Methods-Conclusions-Vulvar lichen sclerosus is associated with numerous bladder, bowel, and pain comorbidities. The prevalences of all of these disorders are higher in our subjects than the general population except OAB, which we find at approximately 1/3 that of the general population. Patients with lichen sclerosus should be screened for comorbidities that may affect their health and/or quality of life.

Prospective Clinical and Epidemiologic Study of Vulvar Lichen Sclerosus: Analysis of Prevalence and Severity of Clinical Features, together with Historical and Demographic Associations

“…Thomas et al [16], considering the age at onset in 355 women with anogenital lichen sclerosus, found that 49% of cases occurred in women over 50 years of age and 42% occurred in the reproductive years, while among our patients an onset after 50 years of age was reported by 77.8% of patients and prior to 50 years only by 22.2%. Our findings seem to corroborate that the peak of incidence of VLS in adulthood is characteristically located within the postmenopausal years [17,18,19]. …”

The Impact of Vulvar Lichen Sclerosus on Sexual Dysfunction

“…Vulvar LS has been associated with numerous bladder, bowel, and other pain comorbidities including dyspareunia, burning sensation, and dysuria. 4,5 Vulvar scarring often occurs, at times resulting in problems with intercourse. In patients with advanced disease, the introitus may become narrowed resulting in painful sexual intercourse or preventing intercourse altogether.…”

“…7,8 Studies have evaluated LS and pain showing a significant impact on a woman's quality of life. 5,[9][10][11][12][13][14][15][16][17][18][19][20] Limited data are available focusing specifically on the effect of LS on quality of life (QoL) and sexual function. Two studies have shown that patients with LS report significant impact on all major QoL domains (including those related to sexual issues) except school/studying and work.…”

“…Frequency of orgasm was categorized as never/infrequently, sometimes, or always. Interest in sex was assessed on a five-point scale from 1 (no interest) to 5 (high interest); for analysis purposes, this was categorized as not interested (1-2), neutral (3), or interested (4)(5). Importance of vaginal sexual activity was assessed on a five-point scale, from 1 (not important) to 5 (very important); for analysis purposes, this was categorized as not important (1-2), neutral (3), or important (4)(5).…”

“…Types are not mutually exclusive (participants could indicate more than one type of sexual activity) 4. Scale of 1 (no interest) to 5 (high interest), categorized as interested(4)(5), neutral(3) or not interested (1-2) 5. Scale of 1 (not important) to 5 (very important), categorized as important (4-5), neutral (3) or not important (1-2).LICHEN SCLEROSUS AND SEXUAL DYSFUNCTION…”