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A Woman with Changing Vulvar Anatomy: Sexuality in Women with Lichen Sclerosus


Lichen sclerosus is a chronic inflammatory skin disease and mainly occurs in the anogenital area. Occasionally patients also have extragenital skin abnormalities. It primarily occurs in postmenopausal women. Itching is the main symptom. However, a burning sensation, dyspareunia, and dysuria are frequently reported symptoms. Postinflammatory scarring may cause fusion of the labia minora, narrowing the vaginal introitus and burying the clitoris. The treatment can consist of medical treatment (cortisone creams), psychological counseling, sexological counseling, pelvic floor physical therapy, and, in exceptional circumstances, surgery may help.


  • Lichen sclerosus
  • Women
  • Sexuality
  • Itching
  • Pain
  • Burning sensation
  • Squamous cell carcinoma (SCC)
  • Provoked vestibulodynia (PVD)
  • Lichen planus (LP)
  • Lichen simplex chronicus (LSC)

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  • DOI: 10.1007/978-3-319-40404-2_19
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Fig. 19.2


  1. Jones RW, Scurry J, Neill S, MacLean AB. Guidelines for the follow-up of women with vulvar lichen sclerosus in specialist clinics. Am J Obstet Gynecol. 2014;198(5):496e1–3.

    CrossRef  Google Scholar 

  2. Smith YR, Haefner HK. Vulvar lichen sclerosus: pathophysiology and treatment. Am J Clin Dermatol. 2004;5(2):105–25.

    CrossRef  PubMed  Google Scholar 

  3. Wood PL, Bevan T. Lesson of the week: child sexual abuse enquiries and unrecognised vulval lichen sclerosus et atrophicus. Br Med J. 1999;319(7214):899–900.

    CrossRef  CAS  Google Scholar 

  4. Goldstein AT, Marinoff SC, Christopher K, Srodon M. Prevalence of vulvar lichen sclerosus in a general gynecology practice. J Reprod Med. 2005;50(7):477–80.

    PubMed  Google Scholar 

  5. Eberz B, Berghold A, Regauer S. High prevalence of concomitant anogenital lichen sclerosus and extragenital psoriasis in adult women. Obstet Gynecol. 2008;111(5):1143–7.

    CrossRef  PubMed  Google Scholar 

  6. Powell JJ, Wojnarowska F. Lichen sclerosus. Lancet. 1999;353(9166):1777–83.

    CrossRef  CAS  PubMed  Google Scholar 

  7. British Association for Sexual Health and HIV (BASHH). UK National Guideline on the Management of Vulval Conditions. 2014.

  8. Bradford J, Fischer G. Long-term management of vulval lichen sclerosus in adult women. Aust N Z J Obstet Gynaecol. 2010;50(2):148–52.

    CrossRef  CAS  PubMed  Google Scholar 

  9. Chi CC, Kirtschig G, Baldo M, Brackenbury F, Lewis F, Wojnarowska F. Topical interventions for genital lichen sclerosus. Cochrane Database Syst Rev. 2011;(12).

    Google Scholar 

  10. Fistarol SK, Itin PH. Diagnosis and treatment of lichen sclerosus an update. Am J Clin Dermatol. 2013;14(1):27–47.

    CrossRef  PubMed  Google Scholar 

  11. Nederlandse Vereniging voor Dermatologie en Venereologie (NVDV). Richtlijn Anogenitale lichen sclerosus. 2012.

  12. Neill SM, Lewis FM, Tatnall FM, Cox NH. British Association of Dermatologists’ guidelines for the management of lichen sclerosus 2010. Br J Dermatol. 2010;163(4):672–82.

    CrossRef  CAS  PubMed  Google Scholar 

  13. Perez-Lopez FR, Ceausu I, Depypere H, Tamer E, Lambrinoudak I, Rees M, Schenck-Gustafsson K, Tremollieres F, van der Schouw YT, Simoncini T. EMAS clinical guide: vulvar lichen sclerosus in peri and postmenopausal women. Maturitas. 2013;74(3):279–82.

    CrossRef  PubMed  Google Scholar 

  14. Sherman V, McPherson T, Baldo M, Salim A, Gao XH, Wojnarowska F. The high rate of familial lichen sclerosus suggests a genetic contribution: an observational cohort study. J Eur Acad Dermatol. 2010;24(9):1031–4.

    CAS  Google Scholar 

  15. Funaro D. Lichen sclerosus: a review and practical approach. Dermatol Ther. 2004;17(1):28–37.

    CrossRef  PubMed  Google Scholar 

  16. Van De Nieuwenhof HP, van der Avoort IAM, De Hullu JA. Review of squamous premalignant vulvar lesions. Crit Rev Oncol Hemat. 2008;68(2):131–56.

    CrossRef  Google Scholar 

  17. Dalziel KL. Effect of lichen-sclerosus on sexual function and parturition. J Reprod Med. 1995;40(5):351–4.

    CAS  PubMed  Google Scholar 

  18. Goldstein A, Creasey A, Pfau R, Phillips D, Burrows L. Sexual dysfunction in women with lichen sclerosus. J Sex Med. 2010;7:137.

    Google Scholar 

  19. Van De Nieuwenhof HP, Meeuwis KAP, Nieboer TE, Vergeer MC, Massuger LF, De Hullu JA. The effect of vulvar lichen sclerosus on quality of life and sexual functioning. J Psychosom Obstet Gynecol. 2010;31(4):279–84.

    CrossRef  Google Scholar 

  20. Thorstensen KA, Birenbaum DL. Recognition and management of vulvar dermatologic conditions: lichen sclerosus, lichen planus, and lichen simplex chronicus. J Midwifery Women Health. 2012;57(3):260–75.

    CrossRef  Google Scholar 

  21. Cooper SM, Gao XH, Powell JJ, Wojnarowska F. Does treatment of vulvar lichen sclerosus influence its prognosis? Arch Dermatol. 2004;140(6):702–6.

    CrossRef  CAS  PubMed  Google Scholar 

  22. Renaud-Vilmer C, Cavelier-Balloy B, Porcher R, Dubertret L. Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease. Arch Dermatol. 2004;140(6):709–12.

    CrossRef  PubMed  Google Scholar 

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Correspondence to Moniek M. ter Kuile PhD .

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ter Kuile, M.M., Gaarenstroom, K.N. (2017). A Woman with Changing Vulvar Anatomy: Sexuality in Women with Lichen Sclerosus. In: Paarlberg, K., van de Wiel, H. (eds) Bio-Psycho-Social Obstetrics and Gynecology. Springer, Cham.

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