Lichen sclerosus and trauma

When I went to my doctor 4 years ago looking for answers to my health issues, she missed it. Neither she nor I knew what we were looking for. I just knew something was not right.

Last year, I committed to find answers. When my doctor confirmed my suspicions of LS, I broke down in tears. “Now I need two appointments,” I sobbed. “I need a doctor to treat this condition and a therapist to help me deal with it.”

Photo by Viktoria Slowikowska on Pexels.com

So, what about lichen sclerosus and trauma?

While waiting for my appointment with a GYN at a dermatology clinic, I booked 2 sessions with a trauma-informed therapist. Neither of those sessions involved much conversation about the challenging effects of LS. They did, however, shine a light on some unresolved traumas.

In the post, What causes lichen sclerosus?, one of the commonly-cited causes includes trauma.

According to Early Connections:

There are three main types of trauma: Acute, Chronic, or Complex

  • Acute trauma results from a single incident.
  • Chronic trauma is repeated and prolonged such as domestic violence or abuse.
  • Complex trauma is exposure to varied and multiple traumatic events, often of an invasive, interpersonal nature. 1

There are also emotional and physical traumas. Childbirth, with or without episiotomy, creates trauma on the vulva, particularly at the 6 o’clock area, or fourchette. Intercourse may continue to tear this area, creating chronic physical trauma at one particular site.

According to an article in Obstetrics and Gynecology International:

A well-known manifestation of VLS is the Koebner phenomenon. It is described as the occurrence of lesions at sites of injured or traumatized skin due to scratching or sexual activity. Thus, repeated trauma and irritation to the area may act as a precipitating factor for the disease. Radiation has also been implicated as one of the causal factors. 2

Now, I’m not a doctor or a therapist. I don’t know your particular circumstances. I do know that to address LS, we need to consider all of the possible elements involved.

It is assumed that trauma plays a significant role as trigger in the development of lichen sclerosus. Such traumas include scratching, friction (e.g., caused by tight clothing), occlusion, surgical procedures or sexual abuse during childhood. 3

National Library of Medicine

I found it strange when my pelvic floor therapist asked me if I remembered ever injuring my vulva as a child, like on a bike. It was an odd question and yet immediately reminded me of when I fell vulva-first onto the frame of my bike at 5 years-old. It was so painful. Clearly so, because I don’t have a ton of memories from that time but I sure remembered that!

Again, LS is a condition unique to the individual and much is still to be known about causes and treatment. Not everyone with LS has a trauma component…

…though if you didn’t have trauma before your LS diagnosis, you probably experienced some after.

While identifying the cause of your suffering may come with some relief, it’s not an easy diagnosis to receive. Neither is it the hardest. Hopefully, through information, support and sharing of resources, you find the post-LS trauma minor.

Seek out community, nourish yourself and assemble your team of health care practitioners. I wrote about the benefits of having a good PF therapist on your side in Lichen sclerosus and pelvic floor therapy. If trauma has a history to unravel in your life, consider adding a trauma-informed therapist or psychologist to your team. If you need help, ask your doctor for resources on where to find one.

Oh, and make sure your bike has a frame with an angled bar. Or padded. Or just walk.

Much love,

Stephanie

Read the next post in the series: More musings on lichen sclerosus

If you find value in my content, thank you for supporting me by purchasing one of my books.

**This blog is meant to inform, not diagnose or treat specific health conditions. It is not a substitute for professional medical advice, diagnosis and treatment. Always consult your doctor or health care practitioner.

1 https://earlyconnections.mo.gov/professionals/trauma-informed-care

2 https://www.hindawi.com/journals/ogi/2020/7480754/

3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904529/

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