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

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.

The Impact of Vulvar Lichen Sclerosus on Sexual Dysfunction

“…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. 7,21 The results from our subjects suggest a similar negative influence of LS on sexual function as was shown in these other studies. van de Nieuwenhof and colleagues explored details of sexual function in women with LS and healthy controls, demonstrating that subjects with LS reported significantly lower sexual satisfaction and function than controls.…”

“…These symptoms are present for many women suffering from this disease. 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.…”

Patients’ Experience of Psoriasis in the Genital Area

“…Besides, it is known that in patients with vulvar lichen sclerosus, which like psoriasis is clinically characterized by itching and burning and has also a chronic nature, there is a correlation between the intensity and/or frequency of vulvar symptoms (pain, burning, itching, dryness) and a poorer quality of life [20]. Also, patients with vulvar lichen sclerosus who experience more itch and/or pain report more sexual distress and more problems regarding several dimensions of sexual functioning [21]. …”

Contact Allergy and Vulvar Lichen Sclerosus et Atrophicus

“…These women are severely affected; studies indicates that the disease has a large effect on quality of life and many suffer from sexual dysfunction as well [5,[10][11][12]. Even a small improvement will make a difference for the women and therefore we do think that patch testing these patients is important.…”

“…Pruritus, pain and dyspareunia are common symptoms and as a result there may be a complete preclusion of sexual intercourse. Women and young girls with the disease describe restrictions in their lifestyle and a reduced quality of life [5,[10][11][12].…”