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Sex and Lichen Sclerosus

Sex and Lichen Sclerosus | Jo Divine

Lichen Sclerosus is a skin condition that, according to the Association for Lichen Sclerosus and Vulval Health Association, can affect anything from 1 in 30 to 1 in 1000 people worldwide, however it is impossible to get an accurate figure.

Typically it is found in the genitals of postmenopausal women, however children, women and men of all ages can be affected. While it is unclear what causes the disease, it is generally thought to be linked to an overactive immune system. It is not an STI and cannot be contracted during sex.

While Lichen Sclerosus can affect other areas such as the upper-arms, shoulders, back and breasts, it is more commonly found on the vulva, near the clitoris and around the head of the penis. Symptoms include itchy white patches of skin that start forming together to create a larger patch, red blood blisters caused by thinning of the skin and difficulty in having sex. The thinning of the skin can lead to tiny cracks and abrasions, making you more prone to thrush.

Penetration becomes painful due to the narrowing of the entrance to the vagina as well as the delicate skin becoming more prone to tearing and scarring. If left untreated, in some cases the vulva fuse together over the clitoris.

The skin around the head of the penis and foreskin can tear or tighten, making it difficult for the foreskin to retract.

While Lichen Sclerosus itself is not cancerous, it does increase the risk of women developing vulval cancer in the future, affecting around 1 in 20 women according to the NHS. Therefore, regularly self-checking of the vulva is recommended as the earlier signs of cancer developing, the easier it is to treat. If you have Lichen Sclerosus and notice any changes, it is extremely important to tell your doctor to get things checked out!

Treating Lichen Sclerosus

Unfortunately there is currently no cure for Lichen Sclerosus and it is a long-lasting disease, however symptoms can be alleviated after seeking help from a medical professional. The main treatment for Lichen Sclerosus, also known as LS, is a steroid or cortisone cream or ointment to control symptoms.

While symptoms may never fully go away, there are many ways of keeping on top of them. Using fragrance free soaps, avoiding scratching and wearing loose clothing can help ensure further irritation of the skin is prevented.

For men, keeping the skin clean and dry under the foreskin is important. Often urine can irritate the tissues so ensuring that the skin is completely dry after urinating can help.

In severe cases of Lichen Sclerosus, surgery may be needed if the vagina has become too narrow. However, surgery is more common in cases of Lichen Sclerosus in men as they are circumcised to remove the affected skin.

Regaining your sex life

Although the symptoms of Lichen Sclerosus mean that penetration is not possible, it does not mean that your sex life has to suffer. While many GPs prescribe medical dilators to stretch the vagina, using a range of slim vibrators feels much more pleasurable for women due to the added stimulation from the vibrations.

If you prefer to use dilators to help you overcome vaginal tightness, the Inspire Silicone Dilator Kit offers 5 graduated dilators made from velvety soft silicone which are extremely flexible, unlike hard medical dilators and feel very gentle on the delicate skin of the vulva and vagina. The easy to use loop handle makes them comfortable to hold, and the gentle tapered shape and varied sizes allows you to increase the insertion size at a rate that is comfortable to you.

Our vibrators are made from skin safe silicone which has a velvety touch and is gentle on the delicate tissues of the vagina and clitoris.

Using an unassuming vibrator such as the Rocks Off Slinky Pinky as a starting point is great for women experiencing vaginal tightness as it is discreet enough for external stimulation. It may take time, but by increasing the amount of stimulation to the clitoris and vulval area, penetration may once again be possible.

For women wanting to enjoy penetrative sex with their partner again, they may find it easier to work their way up through different vibrator sizes, just like medical dilators. The OhMiBodCuddle Mini, OhMiBod Cuddle and Je Joue Uma are great vibrators for this as they are powerful yet petite, stimulating and stretching the vagina comfortably and pleasurably.

The PicoBong Zizo is the largest vibrator we offer in the health brochure and may be suitable once you are able to dilate your vagina comfortably. It is slightly smaller than the average sized penis, so hopefully will enable you to enjoy penetrative sex.

For men, using a good pH balanced sexual lubricant is important when gently mastubating to keep the foreskin from tightening and the tissue from tearing.

It’s also recommended that you use a sexual lubricant as part of this self-help treatment.

Ensure that you choose a product that will not irritate the delicate tissues of the vulva and vagina, especially as LS can cause the skin to thin making you more prone to thrush. YES Organic Lubricant is great as it nourishes the skin too, alleviating any vaginal dryness and making penetration feel better.

Many sexual lubricants contain glycerin, even those on prescription which can cause thrush, also glycols which are vaginal irritants and parabens which are oestrogenic. Many are not pH balanced to that of the vagina flora and may cause vaginal infections such as thrush and bacterial vaginosis. Some water based lubricants have a high osmolority such as KY jelly and other water based lubricants, even some om prescription and draw moisture out of the vagina walls rather than moisturing them, exaccerbating vaginal dryness.

YES Oil Based Lubricant is particularly good for improving skin health as it is made from the finest quality of plant oils, deeply nourishing the skin for better moisturisation.

YES Vaginal Moisturiser is a long lasting natural vaginal moisturiser, pH balanced to match and maintain vaginal health.

Free from glycerine, parabens, glycols and preservatives which are common ingredients found in many vaginal lubricant it will not irritate the delicate tissues of the vagina and vulva.

Increasing sexual intimacy

While penetration may not be possible, this does not mean you cannot still share sexual pleasure with your partner. Massage, mutual masturbation, oral sex and even cuddling can bring you closer together and maintain a certain level of intimacy together.

The Satisfyer Pro 2 uses air pusle stimulation which is gentlyer on the tissues of the clirotis than classic vibrators which may leave you feeling desenitised after prolonged use. The lowest wetting is ideal for thsoe who experiecne issues with hypersensitivity.

If you are using sex toys on yourself to relax, incorporate your partner in this process. Show them how you like to be touched with a clitoral stimulator or let them use one on you.

There are sex toys designed to be enjoyed together too such as the Doppio 1 and Doppio 2, or male sex toys to enhance his sexual pleasure such as the Pulse III Solo Essential and Duo from Hot Octopuss. These are great products that are versatile too, and can be used when the penis is flaccid or erect so men experiencing symptoms of ED can still enjoy sexual pleasure.

A lack of lubrication can increase discomfort, so in addition to using a lubricant ensure that foreplay is not neglected, as this is a great way to increase arousal as well as sexual intimacy.

Communication

Women suffering from Lichen Sclerosus can find it stressful, especially after going through the menopause with the impact of hormonal changes affecting their sex life.

Men can feel the same way, often avoiding sex, which in turn, can make their partner feel rejected. These feelings of anxiety can affect your partner, who doesn’t want to see you in pain or discomfort but may not know how to help.

Being open both verbally and physically with your partner will, in the long run, make you both feel better, and will ultimately increase your intimacy as a couple.

It’s also important to speak to your doctor as soon as you notice any changes to your vulva or penis. Lots of people are uncomfortable talking to their GPs about sexual issues, but seeking advice and treatment early on can prevent weeks, months or even years of discomfort. Long-term health issues like Lichen Sclerosus won’t simply go away: it’s important to be proactive concerning your sexual health and be in control of your overall wellbeing.

At Jo Divine we believe that sexual health and sexual pleasure go hand in hand and have created a health brochure with suitable products to help people with sexual issues. Working with medical professionals, we hope to encourage patients and HCPs alike in talking more freely about sexual problems.

We also have male products in our main catalogue.

A health issue doesn’t mean your sex life will have to stop!

Useful Websites
Vulval Pain Society : www.vulvalpainsociety.org
Pelvic Pain Society: www.pelvicpain.org.uk
Lichens Sclerosus : www.lichensclerosusukawareness.weebly.com
British Society for the Study of Vulval Disease : www.bssvd.org
Royal College of Obstetricians and Gynaecologists : www.rcog.org.uk
British Association of Dermatologists : www.bad.org.uk
UK Lichens Planus : www.uklp.org.uk
International Society for the Study of Vulval Disease : www.issvd.org
British Association for Sexual Health and HIV : www.bashh.org
Pelvic, Obstetric and Gynaecology Physiotherapy:https://pogp.csp.org.uk/