Your HEALTH

Got a medical problem or need health advice? Ask GP Dr Amir Khan

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I've recently been diagnosed with lichen sclerosus and I'm frightened.

No one seems to talk about it. How do I manage it?

Lichen sclerosus is more common than many people realise, particularly in women going through perimenopause and menopause, yet it's a condition that's rarely spoken about.

It affects the skin of the vulva - that's the outside of the female genital tract. It can cause itching, soreness, splitting, discomfort during sex and sometimes changes in the appearance of the skin. The silence around it can leave some women feeling isolated or ashamed, but please know you are not alone. We believe lichen sclerosus has an autoimmune component. This means that the immune system becomes overactive and causes inflammation in vulval skin. Hormonal changes, especially falling oestrogen levels around menopause, can make symptoms more noticeable.

The most effective treatment is a strong steroid ointment, used regularly at first, then as ongoing maintenance. Some women worry about using steroids in such sensitive areas, but when used as advised, they are safe and actually protect the skin, helping to prevent long-term scarring or narrowing. Think of it as calming your immune system locally.

My friend has just been diagnosed with vulval cancer, which she thought was thrush. I'd never heard of it - what should I be looking out for?

Vulval cancer is far less talked about and that lack of awareness means many women don't recognise symptoms early. It's not as common as the other gynaecological cancers, but it's also not rare, and cases are increasing, particularly in postmenopausal women. The problem is women often dismiss symptoms as irritation, thrush or just ageing.