Lichen Sclerosus: a Serious Cause for Itching (Down There)

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In this episode of Opt to Thrive we explore a condition that can be sometimes mistaken for normal menopausal symptoms—but shouldn’t be ignored. Dr. Sims shines a spotlight on Lichen Sclerosus (LS), a chronic skin condition that primarily affects the vulva and can have serious, even life-threatening consequences if left untreated.

Prompted by the overwhelming response to recent viral social media posts (with nearly 2 million views!), this conversation explores why LS remains so underdiagnosed, what makes it different from more familiar issues like thrush, dermatitis, or genitourinary syndrome of menopause (GSM), and why talking about “itchy bits” matters more than ever.

In this episode, you’ll learn:

• What Lichen Sclerosus is, who it affects, and how it presents at various stages
• Why LS often goes undiagnosed for years—and the serious risks this poses
• How it’s different (and sometimes overlaps) with GSM
• The role of hormones, autoimmune conditions, and the microbiome
• Effective treatment options—including potent topical steroids
• When to consider biopsy, systemic treatment, or even surgery
• Practical tips for vulval care and what to avoid

Dr. Sims also shares a moving story from early in her GP training that underscores the importance of early detection and regular monitoring—especially in preventing complications like squamous cell carcinoma (SCC).

Whether you're a woman navigating midlife, a healthcare provider, or simply want to learn more about this rarely discussed topic, this is an essential listen.

🎧 Referenced Episode: Episode 9: Let’s Talk About Sex