117 - Painful Sex: The Story of Lichen Sclerosus, a Shockingly Under-Diagnosed Post-Menopause Skin Condition, Part 2

Let's continue our conversation about lichen sclerosus, specifically focusing on treatment options this time. The treatments and therapies I'm discussing in this episode can actually be quite useful for many vaginal conditions and are something all women should know about. The first line of approved care for lichen sclerosus is a local application of a steroid medication, usually in an ointment form. Prolonged use of a steroid medication can lead to thinning of the skin, but it is particularly useful for women dealing with significant itching and plaque formation. Keep in mind that treatment does not mean reversing the course of the disease. Another treatment option—one I rarely use due to side effects and cost—is a topical tacrolimus. Tacrolimus is a potent immune system suppressant, and it can decrease the inflammation associated with this skin condition (as well as some others). It is only intended for short-term use, and can be compounded for application. There are also some unconventional options for care, including topical estrogen. It can improve dryness, reduce pain during sex, and support elasticity. Estrogen can also be used as treatment in the form of pellet therapy. This treatment option can help women return to more comfortable intimacy in as little as 4-6 weeks. Nothing is perfect, but estrogen pellets offer more consistent exposure than other options. Testosterone is another hormone that can be used in the treatment of lichen sclerosus. This hormone plays an important role in skin quality, and it has been demonstrated in improving skin elasticity and strength. Side effects and an adjustment of dose can reduce the risk of unwanted side effects.   Connect with Dr. Cernaianu https://www.herabeautyandwellness.com/  https://www.instagram.com/herabeautyandwellness/  https://www.facebook.com/people/Hera-Healthcare-Mirela-Cernaianu-MD/100063462643162/