Sexological Centre, Aalborg University Hospital, Aalborg 9000, Denmark.
Department of Clinical Medicine, Sexology Research Centre, Alborg University, Aalborg 9000, Denmark.
J Sex Med. 2023 Mar 31;20(4):488-497. doi: 10.1093/jsxmed/qdad018.
Women with lichen sclerosus (LS) may suffer sexually because of dyspareunia, fissures, and introital narrowing. However, the literature remains limited on the biopsychosocial aspects of LS and its impact on sexual health.
To examine the biopsychosocial aspects and impact of LS on the sexual health of Danish women with vulvar LS.
The study was conducted with a mixed methods approach, including women with LS from a Danish patient association. The quantitative sample consisted of 172 women who completed a cross-sectional online survey that included 2 validated questionnaires: the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS). The qualitative sample consisted of 5 women with LS who volunteered for audiotaped, individual, semistructured interviews.
This mixed methods study combined data from 2 quantitative questionnaires (FSFI and FSDS) with qualitative interviews to achieve a comprehensive insight into the biopsychosocial aspects of sexual health in women living with LS.
The sexual function of women with LS was considerably affected, with FSFI scores below the cutoff value of 26.55, indicating a risk of sexual dysfunction. On average, 75% of the women were sexually distressed, with a total FSDS score of 25.47. Furthermore, 68% of the sexually active women were considerably affected in terms of sexual function and sexual distress, thus meeting international criteria for sexual dysfunction. However, a negative impact on sexual function was not always related to sexual distress and vice versa. The qualitative analysis identified 4 overarching themes: (1) decrease in or loss of sexual activity, (2) interference with relationship dynamics, (3) importance of sex and intimacy - loss and restoration, and (4) worries about sexual insufficiency.
Insight into the influence of LS on sexual health is important for health care professionals, including doctors, nurses, sex therapists, and physiotherapists, to provide the best guidance, support, and management for women with LS.
The strengths of the study are its use of a mixed methods design and the inclusion of sexual function and sexual distress. A limitation is related to the properties of the FSFI regarding women with no sexual activity.
LS has a considerable influence on women's sexual health in terms of sexual function and sexual distress, as supported by quantitative and qualitative measures. Our understanding of the complex interactions among sexual activity, intimate relations, and causes of psychological distress has been enriched.
患有硬化性苔藓（LS）的女性可能会因性交疼痛、皲裂和阴道入口狭窄而在性生活中感到痛苦。然而，关于 LS 的生物心理社会方面及其对性健康的影响的文献仍然有限。
研究丹麦患有外阴 LS 的女性的 LS 对其性健康的生物心理社会方面的影响。
该研究采用混合方法进行，包括来自丹麦患者协会的 LS 女性。定量样本由 172 名女性组成，她们完成了一项横断面在线调查，其中包括 2 项经过验证的问卷：女性性功能指数（FSFI）和女性性困扰量表（FSDS）。定性样本由 5 名 LS 女性组成，她们自愿接受录音、个人、半结构式访谈。
这项混合方法研究结合了 2 个定量问卷（FSFI 和 FSDS）和定性访谈的数据，以全面了解 LS 患者的性健康的生物心理社会方面。
LS 对女性的性健康有相当大的影响，FSFI 得分低于 26.55 的临界值，表明存在性功能障碍的风险。平均而言，75%的女性存在性困扰，FSDS 总分为 25.47。此外，68%的活跃女性在性功能和性困扰方面受到相当大的影响，因此符合国际性功能障碍标准。然而，性功能的下降并不总是与性困扰相关，反之亦然。定性分析确定了 4 个总体主题：（1）性活动减少或丧失，（2）影响关系动态，（3）性和亲密关系的重要性-丧失和恢复，以及（4）对性不足的担忧。
了解 LS 对性健康的影响对医疗保健专业人员（包括医生、护士、性治疗师和物理治疗师）很重要，以便为 LS 患者提供最佳的指导、支持和管理。
该研究的优势在于采用混合方法设计，并包括性功能和性困扰。一个局限性与 FSFI 对无性行为女性的特性有关。
