Painful Sex? It Could Be Vulvar Disease

Lichen Simplex Chronicus

Lichen Simplex Chronicus is a very different condition than contact dermatitis, but many of the symptoms are similar: red, inflamed and intensely itchy skin. The cause isn’t entirely clear but irritants contribute. It’s more likely in people with eczema and psoriasis. The symptoms can get really intense with this condition and cause loss of vaginal lubrication, and loss of sexual arousal, desire and orgasm. All of this can understandably lead to demoralization, depression, anxiety and sleep disturbances. The doctor may take a small circle of skin (called a skin or “punch” biopsy) about the diameter of a pencil eraser to make the diagnosis and to be sure there is no skin cancer.

Lichen Sclerosus

Lichen sclerosis is a chronic inflammation of the vulva that affects 1 in 70 women. It usually affects young girls before puberty and menopausal woman. Sometimes it can be a very mild disease and other times the itching can be maddening. As with the Lichen Simplex Chronicus, there can also be an associated risk for skin cancer of the vulva. The problem can also lead to chronic pain in the vulva.

Lichen Planus

Lichen Planus is an autoimmune disease of the vulvar tissue that affects about 1 percent of women between the ages of 30 and 60. Again, the common symptoms are redness, itching, burning and painful sex.

One of the important organizations for you to know about with these types of problems is the National Vulvodynia Association, where you can find helpful information.

Treatment

For each of these conditions, there will be slightly different treatments. For contact dermatitis, the primary goal is to find out what is causing the allergy. This may take some investigation, but getting rid of contact with that material is a key part of treatment. The good thing is that once you stop using the irritating substance, the problem will stop. More treatment may be needed (see below).

For the other conditions, treatment will depend in part on how bad the inflammation is. Sometimes there may be a crack in the skin called a fissure or even a small ulcer. Sometimes the doctor may prescribe you a topical steroid ointment twice a day such as 1 percent triamcinolone. For worse cases, your doctor may suggest a stronger steroid such as clobetasol 0.05 percent. Ice packs and antihistamines can help reduce the itching.  One of the big problems is that the itching is so intense that many women will scratch the area while asleep which makes it worse. To help prevent that, your doctor might prescribe a low-dose antidepressant such as a tri-cyclic antidepressant.

Each case is different, but with the proper diagnosis, most women will get the relief they need and be able to eliminate the pain and put the joy back into her sex life. To see my video on another cause of painful sex called atrophic vaginitis, please watch the video below.

To help you with the stress that is often associated with vulvar dermatosis as well as other conditions, click the link for my free Stress-Busters eBook.