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Rates of Self-Reported Urinary, Gastrointestinal, and Pain Comorbidities in Women With Vulvar Lichen Sclerosus

Berger, Mitchell B. MD, PhD1; Damico, Nicholas J. BS1; Menees, Stacy B. MD, MS2; Fenner, Dee E. MD1; Haefner, Hope K. MD3

Journal of Lower Genital Tract Disease: July 2012 - Volume 16 - Issue 3 - p 285–289
doi: 10.1097/LGT.0b013e3182562f1e
Original Articles

Objective The study aimed to determine the prevalences of comorbid disorders in women with vulvar lichen sclerosus.

Materials and Methods A retrospective review of self-administered questionnaires regarding the health history of 308 women with lichen sclerosus seen at a vulvar clinic between 2006 and 2011 was performed. Responses to questions about urinary (overactive bladder [OAB], urinary incontinence [UI], and stress UI), gastrointestinal (inflammatory bowel diseases, constipation, and irritable bowel syndrome), thyroid dysfunction and pain (interstitial cystitis, fibromyalgia, temporomandibular joint disorder, and vulvar pain) disorders were collected. The percentage of subjects self-reporting each comorbidity was compared with the published prevalence in the general population using a single-value binomial test.

Results Subject demographics (data presented as median [range] or percentage): age, 56.4 years (20.0–92.5); body mass index, 27.5 kg/m2 (17.4–53.1); parity 2 (0–10); white, 92.9%; and biopsy proven 65.6%. Prevalences of self-reported comorbidities in our subjects are as follows: OAB, 15.3%; UI, 38.6%; stress UI, 27.9%; inflammatory bowel diseases, 1.9%; constipation, 32.5%; irritable bowel syndrome, 19.5%; thyroid dysfunction, 33.1%; interstitial cystitis, 2.6%; fibromyalgia, 9.1%; temporomandibular joint disorder, 13.0%; and vulvar pain, 83.1%. The prevalence of each disorder is significantly different from that in the general population, with all p values ≤ .02.

Conclusions Vulvar lichen sclerosus is associated with numerous bladder, bowel, and pain comorbidities. The prevalences of all of these disorders are higher in our subjects than the general population except OAB, which we find at approximately one third of the general population. Patients with lichen sclerosus should be screened for comorbidities that may affect their health and/or quality of life.

Women with lichen sclerosus report elevated rates of various urinary, gastrointestinal, and pain disorders and lower rates of overactive bladder, compared with those of the general population.

1Division of Urogynecology, Department of Obstetrics and Gynecology, 2Division of Gastroenterology, Department of Internal Medicine, and 3Center for Vulvar Diseases, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI

Reprint requests to: Mitchell B. Berger, MD, PhD, L4000 Women’s Hospital, 1500 E. Medical Center Dr, SPC 5276, Ann Arbor, MI 48109-5276. E-mail:

The authors acknowledge the investigator support from by the National Institutes of Health through the Office for Research on Women’s Health Specialized Center of Research on Sex and Gender Factors Affecting Women’s Health grant P50 HD044406. Dr Fenner received research support from American Medical Systems.

Results from this study were presented as an oral abstract at the XXI World Congress of the International Society for the Study of Vulvovaginal Disease (Paris, France; September 2011).

©2012The American Society for Colposcopy and Cervical Pathology