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The Female Genital Self-image Scale in Adult Women With Vulvar Lichen Sclerosus

Hodges, Kelly R. MD1; Wiener, Courtney E. MD1; Vyas, Anuja S. MD2; Turrentine, Mark A. MD1

Journal of Lower Genital Tract Disease: July 2019 - Volume 23 - Issue 3 - p 210–213
doi: 10.1097/LGT.0000000000000481
Original Research Articles: Vulva and Vagina

Objective There is no agreed upon standard way to measure vulvar lichen sclerosus disease severity. The Female Genital Self-Image Scale (FGSIS) is a validated survey tool assessing female genital self-image and is positively correlated with women's sexual function. A lower score represents a negative genital self-image. We evaluated the FGSIS in women with vulvar lichen sclerosus.

Methods Women with biopsy-proven lichen sclerosus and women presenting for routine gynecologic care without lichen sclerosus matched by age were surveyed with the 7-item FGSIS. National surveys of healthy women in the United States have shown the mean 7-item FGSIS score is 21. To detect one standard deviation (20% absolute difference) between groups with a power of 80% at p < .05, 15 women would are needed in each group.

Results Sixteen women with lichen sclerosus and 16 matched controls were surveyed between February and July 2018. The mean ± SD age of women with lichen sclerosus was 56.8 ± 13.5 years, 94% were white, 69% married, 81% college educated, 69% postmenopausal, and 18% on hormone replacement therapy. None of these differences were statistically different from control women. Women with vulvar lichen sclerosus had a significantly lower median 7-item FGSIS when compared with control subjects, 18 (interquartile range = 16–21) versus 25 (interquartile range = 23–27), respectively, Mann–Whitney U test, p < .001.

Conclusions Women with vulvar lichen sclerosus have a lower score on the 7-item Female Genital Self-Image Scale compared with healthy controls.

1Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, TX; and

2Department of Obstetrics & Gynecology, Methodist Hospital, Houston, TX

Reprint requests to: Mark Turrentine, MD, Baylor College of Medicine, 6651 Main St, Suite F1020, Houston, TX 77030. E-mail:

The authors have declared they have no conflicts of interest.

The Baylor College of Medicine Institutional Review Board gave approval for this study (Protocol Number H-40837).

Online date: May 23, 2019

Copyright © 2019 by the American Society for Colposcopy and Cervical Pathology