Lifting the lid on Lichen Sclerosus – what is it, and does it affect fertility?

Lichen sclerosus (that’s like-en skler-oh-sus) is a fairly uncommon skin condition that can create patches of itchy, white skin in the genital area.

And while it can lead to some uncomfortable symptoms, it’s important to understand its impact on fertility, pregnancy, and general health, as you navigate diagnosis and treatment options.

In this quick guide, we’ll dive into what lichen sclerosus is, and unpack whether there’s a lichen sclerosus fertility link or not, as well as explain how you can manage symptoms when you’re trying to conceive – with expert insight from Samantha M. Pfeifer, M.D.

What is lichen sclerosus, and who can get it? 

“Lichen sclerosus (LS) is a chronic, inflammatory skin condition”, explains Dr. Pfeifer. “It leads to itching, thinning and patches of white, shiny scar-like skin that affects the area around the vulva and labia.”

The condition most commonly affects women, including those post-menopause, but up to 50% of cases may occur in women of reproductive age. 

Although the condition isn’t fully understood and is most probably underdiagnosed, LS is thought to be linked to autoimmune activity, where the body’s immune system mistakenly attacks its own skin cells.

Symptom spotting

Symptoms can vary, but if you have lichen sclerosus, or suspect you might have it, you might notice the following.

• Itching and discomfort in the vulvar area
• White, patchy areas on the skin that may thin or wrinkle over time
• Pain or bleeding, particularly during sex
• Skin tears, especially in areas that have been scratched or irritated

“It can be a very irritating condition”, says Dr. Pfeifer.

Does lichen sclerosus affect fertility?

No, lichen sclerosus does not affect fertility. Although it can cause significant changes to the vulvar skin, it doesn’t interfere with your reproductive organs. 

This means that your ovaries, fallopian tubes, and uterus are not affected by LS, and your ability to conceive is typically unchanged. If you’re dealing with this condition, your periods and overall fertility profile shouldn’t be affected.

However, if the Lichen Sclerosus is severe, it can lead to scarring, or a reduction in the opening of the vagina. “This can lead to pain with intercourse, as the tissue there may not stretch as easily, but it shouldn’t prevent people getting pregnant”, says Dr. Pfeifer.

“Fortunately, there are treatments for it that can be really helpful”, explains Dr. Pfeifer. Many women with LS can still maintain a healthy sex life – skip down for more on this.

Does lichen sclerosus affect pregnancy?

Once pregnant, you may still wonder if your lichen sclerosus condition could impact the pregnancy itself or pose risks during delivery. The answer here is also no – lichen sclerosus does not affect the course of a pregnancy or pose any risk to your baby.

It’s also helpful to know that many women with LS successfully have vaginal deliveries, as Dr. Pfeifer explains. “While the skin changes associated with LS may raise some questions about childbirth in very very severe cases, this doesn’t occur frequently.”

However, if you’re managing active symptoms or have concerns about tears during delivery, your healthcare provider can discuss options for managing LS symptoms before labor.

Can pregnancy cause lichen sclerosus?

For some, lichen sclerosus symptoms may first appear or worsen due to hormonal changes, leading to the question, “can pregnancy cause lichen sclerosus?” 

Although pregnancy doesn’t directly cause LS, hormone fluctuations, particularly in estrogen, may trigger symptoms in some people. 

Pregnancy and other life stages, like menopause, do bring hormonal shifts with them that may aggravate LS flare ups, even if they don’t cause the condition itself.

Managing lichen sclerosus while trying to conceive

Living with lichen sclerosus while trying to conceive (TTC) means staying proactive with symptom management, and leaning on lifestyle changes that put your comfort first. 

1. Regular check-ins with your healthcare provider are helpful for ensuring that your symptoms are under control. 
2. Chatting through treatment options you can apply or do yourself, like topical steroid creams, can help. Creams like this can help reduce itching, discomfort, and skin changes, allowing you to manage flare-ups more easily.
3. Certain lifestyle adjustments might also be recommended, such as wearing loose, cotton underwear and avoiding tight-fitting clothing to reduce skin irritation, and choosing gentle, water-based lubricants to ease any discomfort during sex.
4. Finding ways to keep your stress levels in check can also go a long way, as emotional stress can sometimes act as a trigger for flare ups, as well as making you feel less in control when you’re actively TTC.

If you’re looking for more support and to find community, there are also a few brilliant spaces over on Instagram – we love Tiffany Remington @ustheremingtons for real, raw insights into pregnancy and parenting with lichen sclerosus, and Jaclyn @thelostlabiachronicles for specific pointers and lifestyle tips.

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