Case study: Lichen sclerosus

For many women the subject of vaginal health is a difficult one to broach, especially if you have difficult or chronic problems down there. It may be harder if you have a male doctor but thankfully there are many female gynaecologists and family doctors these days, which makes it easier.
Recently I saw a 44 year old woman who suffered with the condition known as lichen sclerosus of the vulva and perineum. Lichen sclerosus describes a condition where the tissues of the vulva and perineum are chronically inflamed causing them to become red and hot and a rash develops, which may turn into sores or ulcers, which may become infected with bacteria and candida. The ulcers may be quite deep and the tissues can be eaten away by the inflammation so that permanent scarring results. The clitoris and the vulva may be gradually eaten away and destroyed by the inflammation so that the area becomes disfigured. If the inflammation is not controlled, the affected areas may be susceptible to cancer cells developing with a long term result of vulval or vaginal cancer.

Symptoms of lichen sclerosus include discomfort, burning, pain, discharge and itching in the vulva, perineum and anus. The cause of lichen sclerosus is autoimmune dysfunction, which results in the immune system attacking the tissues of the vulva and perineum. Autoimmune disease is a complex problem and there are always genetic factors involved so that there may be a family history of other autoimmune diseases. Age is also an important predisposing factor and the disease tends to manifest itself and get worse in women in their forties and beyond. General health and lifestyle factors can make lichen sclerosus much worse and things that are bad for your immune system like stress, insomnia, a high sugar intake, smoking, alcohol excess and infections can greatly aggravate the inflammation.

Getting back to the patient I saw recently, she had suffered with lichen sclerosus of her vulva and perineum for many years. She had been to many specialists, including gynaecologists, whose strategy was to suppress the inflammation with cortisone (steroid) creams. The most helpful doctor she had seen to date was a holistic doctor who had picked up an intolerance to gluten and an overgrowth of unfriendly bacteria and candida in her intestines. She had followed this doctor’s advice to avoid all gluten containing foods and sugar and had noticed a huge improvement in her symptoms. However, as is prone to occur, high stress levels occurred, causing her to become less vigilant with her diet and put on weight – of course the lichen sclerosus flared up!

I told this woman that I could help her control this severe disease with a holistic program to balance her hormones and immune system.

This program included –

  • Natural progesterone cream to rub into her inner upper arm once daily – progesterone is not only effective in reducing heavy menstrual bleeding; it is also a natural anti-inflammatory and immune modulator. It’s such a pity that it’s not used more often!
  • Vitamin D 5000 IU daily, as her serum vitamin D was very low – like progesterone, vitamin D is a natural anti-inflammatory substance. Once her serum vitamin D levels were back into the high end of the normal range, the dose would be reduced.
  • Selenium 200mcg daily – this was given in the form of selenomethionine, which is the organic form of selenium. Selenium is an immune modulator with powerful anti-inflammatory properties and is vitally important to consider in all cases of autoimmune diseases. Selenium also exerts a protective effect against many types of cancer.
  • Extra supplements recommended included liquid fish oil, B group vitamins and zinc to reduce inflammation and fight infection.
  • A mild douche solution containing tea tree oil in the correct strength was to be used to douche the vagina and also to make a shallow bath to sit in for 10 minutes daily. Tea tree oil is an excellent natural antibiotic to control bacterial and fungal infections and can be used long term. Do not use straight undiluted tea tree oil as it will burn and irritate!  I recommend this douche solution
  • A probiotic was to be taken daily to repopulate the intestines with healthy bacteria. She was told to follow the Liver Cleansing Diet Book, as this would provide her with the correct foods to promote healthy bacteria in the intestines and would also help her to lose weight. I did emphasise that she should continue to avoid gluten containing foods.
  • To protect the ulcerated areas in the vulva I recommended she use a combination cream containing castor oil and zinc during the daytime
  • To renew and strengthen the tissues of the vulva and perineum I recommended a hormonal cream containing small doses of bio-identical oestrogen and testosterone; this was to be used at night and ½ gram of the cream was to be rubbed into the affected areas of the vulva and perineum.

For more information on these creams – see my book HRT – The Real Truth chapter 7. This book also discusses how to improve your libido and sex life!
I also asked this patient to see her gynaecologist regularly, as he specialised in lichen sclerosus and could check the affected areas every 12 months to pick up any areas suspicions for cancerous changes.

I did reassure her that the program I recommended would work very well and that she could look forward to a major improvement of her problem, so much so, that she should be able to have a normal healthy sex life, as well as good general health. This level of improvement occurs gradually and full benefits are seen after 12 months. By following my program she would also be much less at risk for autoimmune disease to attack other parts of her body.