Fusing of genital area caused by Lichen Sclerosis

[Guest Posts]

Hi there
I am 68 years old, I have LS I was Officially diagnosed 3 years ago but realise I have had it for about 10 years. At the moment I am managing to keep it fairly well under control I apply dermovate twice a week and 20 mg vagifem (vaginally) also twice a week. However, I am worried about the fact that my genital area is disappearing! My clitoris seems to Slowly being buried I am worried I might have problems if the Uretha also becomes buried, I also have bladder incontinence issues.
My question is what can be done about this? Is there anything else I can do to halt the progress of this fusing? I have heard of other sufferers who have been given oral HRT or oestrogen cream.
I would very much welcome your advice.
Many thanks
Eithne

[Dr Nevianna Bordet]

Fusion of the labia in Lichen sclerosus is due to scarring that results from inflammation. So if you control the disease than the risk of fusion is minimised. Potent topical steroids are very effective at controlling LS when used appropriately. But in your case if the fusion is continuing than perhaps your disease is still active and you may need to increase the use of your steroid cream temporarily to prevent further fusion. Your doctor should be able to advise you once they examine you on how often and for how long you need to increase. Once the LS is under control and the fusion is not progressing you can drop back down to the twice weekly maintenance use. Hormone treatment such as HRT and topical oestrogen creams or pessaries do not help with fusion. They are prescribed for vaginal dryness after the menopause and can help you feel more comfortable if this is also present.
Although the clitoris can become buried as the labia fuse at the front over it, the urethra (opening where you pass urine) does not fuse in LS as it is located higher up inside. If the labia fuse completely (and this is extremely rare!), you would need to have an operation to open them up as it is only in this case that you may have problems passing urine.