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pat

by pat
(Solihull)

I am 60 years old and I suffer with leachen serious on the vulva I have steroid cream when it flares up I ache all over and I am always tired my skin is thin will progesterone therapy help me pat

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May 21, 2015
 lichen sclerosus
by: Wray

Hi Pat I'm sorry to hear this as it's not pleasant at all. The cause is unknown, as you're probably aware, some think it could be genetic, some an autoimmune problem. It is more common in women, and more common after menopause, which makes me suspect a lack of progesterone, excess oestrogen. Higher levels of free testosterone have been found too. Treatments tried have been topical testosterone, which has shown no benefit, topical progesterone, a slight benefit, corticosteroids which seems the favoured treatment, photodynamic therapy see here. Plus phototherapy, ie UV light which ultimately makes vitamin D3, and calcitriol, which is a potent natural hormone derived from vitamin D3. Both phototherapy and calcitriol have shown remission of symptoms. Progesterone can help in some cases, but not hugely it seems, see here. Quite possibly the strength of cream used was insufficient, in the study above it was 2% progesterone. And if it was only used in the vulva region, far too little would have been applied. I recommend 100-200mg/day, it would be impossible to get this via a daily or twice daily vulva application. So it's best applied at least twice a day to the vulva, and internally in the vagina. Then the remainder on other areas of the body. Progesterone is an anti-inflammatory, so should give some relief. Vitamin D deficiency could be a cause, please have a test done. Most of us have far too low a level, and the older we get the less we absorb from the sun. Vitamin D affects every cell, it prevents hyperkeratosis and it's an anti-inflammatory. It's excellent for other skin problems. The phototherapy and calcitriol treatments yielded remission of symptoms. Both these treatments require specialised personnel, but vitamin D is readily available and cheap. I would suggest taking 10,000iu's if you find your level low. As an idea, you could get some vitamin D, open a capsule, add the contents to the progesterone cream and rub that on. This is another paper giving a general view and treatment options on Lichen sclerosus. One interesting fact, a lack of vitamin D reduces the benefits of progesterone. Take care Wray

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