The treatment of vulvar lichen sclerosus and female sexual dysfunction.
BACKGROUND
Women with lichen sclerosus (LS) are more likely to have dyspareunia, decreased orgasm, and decreased coital frequency as compared to unaffected women. It is unknown whether standard medical therapy to treat LS results in improved sexual functioning.


OBJECTIVE
To describe sexual function in women with LS and to assess if LS-associated sexual dysfunction decreases after appropriate medical therapy.


METHODS
Women enrolled in a double-blind trial 12-week trial comparing clobetasol vs. pimecrolimus for the treatment of LS were administered the Female Sexual Distress Scale (FSDS) upon enrollment and at the end of the trial. The difference in the total score on the FSDS between the two groups before and after treatment was assessed with a paired t-test.


METHODS
The change in mean FSDS score from baseline to 12 weeks.


RESULTS
A total of 31 out of 36 enrolled women had adequate treatment of LS as determined by a dermatopathologist's evaluation of pre and post-treatment biopsy specimens. The mean baseline FSDS score for the clobetasol group was 29 and, post-treatment, it was 15 (P=0.001). In the pimecrolimus group, the mean baseline FSDS score was 27 and, post-treatment, it was 21 (P=0.001).


CONCLUSIONS
Despite adequate treatment, women with LS continue to have significant sexual dysfunction as assessed by the FSDS.
Summa Health System, Department of Obstetrics and Gynecology, Akron, OH, USA. burrowslj@yahoo.com
Lara J
LJ
Burrows
Alia
A
Creasey
Andrew T
AT
Goldstein
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002990:Clobetasol / Q000627:therapeutic use*; D004414:Dyspareunia / Q000209:etiology*; D005260:Female; D006801:Humans; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012725:Sexual Behavior; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology*; D016559:Tacrolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007724:Vulvar Lichen Sclerosus / Q000150:complications* / Q000188:drug therapy*
D000893:Anti-Inflammatory Agents; C117268:pimecrolimus; D002990:Clobetasol; D016559:Tacrolimus