Pelvic Physical Therapy for Lichen Sclerosus

Presentation

Lichen Sclerosis(LS)  can have a range of symptoms and presentations depending on what stage the condition is in, and not everyone will present with the same symptoms. In the early stage, there can be nonspecific symptoms and include itch, burning sensation, as well as slight redness and swelling in the periclitoral area. Later on, affected skin becomes fragile, and atrophic lesions, fissures, and erosions may occur. The classic presentation of LS is the ivory-white patches in the anogenital area which is the area but it might not be present in the earlier stages. 

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Treatment

 LS can often be confused with vulvovaginal atrophy (GSM) and other vulvar conditions and biopsy is helpful to rule in LS. On the other hand, people can have LS and GSM both in perimenopausal age. 

The first line of treatment and a very crucial one is the use of strong steroid cream in the affected genitalia to stop the progression. For this reason, I always emphasize seeking a vulvar specialist for all my patients and working closely with them to manage the condition. 

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Pelvic Physical Therapy

People with LS can have secondary symptoms such as pain with sex, painful urination, scar tissue, adhesions around the clitoral area, constipation, burning in the vulvar area, and pelvic nerve irritation causing feelings of numbness or pressure of heaviness in the area. Pelvic Physical Therapy with someone who has skill and experience treating patients with LS and is trained in intravaginal, intrarectal, and myofascial techniques and visceral mobilizations can be very helpful and has proven to be successful.