How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. C. Your Own Question
Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 yrs experience, awarding winning educator
Type Your OB GYN Question Here...
Dr. C. is online now

I was diagnosed with Lichen Sclerosis in Nov 2014. Leading

This answer was rated:

I was diagnosed with Lichen Sclerosis in Nov 2014. Leading up to my diagnosis I had had many Drs app., and have suffered a lot of narrowing, deterioration and scarring to the point where intercourse is impossible. The dermovate has given me comfort e, g I can walk without feeling I am going ti split in two. I am 51yrs and thd LS NHS and Macmillan websites have given me advice on the products to ask my Dr. For which has been invaluable. I have yet to meet a GP at my Health Centre or Pharmacist within my small town who can advise re Lichen Sclerosis. Before this, a smear was a routine which was just one of those appointments I just got in with. I have had one sexual partner (my husband of 30yrs) and one pregnancy so boring on the spectrum of sexual health. My recent attempt of a smear filled me with dread. The GP was not LS aware and was ignorant of the difficulties I explained and I had to really stress how I didn't see how a smear was possible. I struggle to insert the thin applicator that comes with the product, 'replens'. After an uncomfortable attempt of which I had to bring to a halt the GP suggested a smear when I eventually see a gynaecologist under general Anaesthetic? I have yet to meet a Practitioner who shows any real knowledge and don't trust this is something to agree to. Surely nothing that doesn't fit awake is goingnto fit just because Im under anaesthetic?

Hi, It's Dr. C. Board certified Ob-gyne with 30+ years of experience. I can help you today. For such situation, I have a woman prep with vaginal estrogen for 2 weeks prior to her exam. Then upon entry into the exam room, she is given 3 cotton balls soaked in local anesthetic. These are placed just inside the opening of the vagina for 10 minutes. When I enter the room in 10 minutes, the balls are left in place while I take the history and we chat. When ready to examine, I remove the cotton balls with a thin forcep. It makes a world of difference regarding patient comfort. I hope this was helpful.
Customer: replied 2 years ago.

Your answer covers thd pain side of thd smear, however I am looking for assurance of no further tearing during procedure as the narrowing is now so


Yes I would use a pediatric speculum in such a situation. For longer term management, I would refer a patient for dilator therapy with a physical therapist who specializes in guiding women with such scarring and narrowed introituses. As a last resort, vaginal reconstruction can be an option is a woman wants to restore sexual capacity. Anything else?
Customer: replied 2 years ago.

Will Lichen Sclerosis eventually destroy any reconstruction?

Not necessarily if it's kept healthy. Usually we'd use a combination of topical estrogen cream along with Clobetasol. That's my preferred steroid but the Dermovate & Trimovate serve that same purpose. Then regular dilator treatment (or regular sex) to upkeep. Anything else?
Dr. C. and other OB GYN Specialists are ready to help you