Assessing the Impact of Vulvodynia and Lichen Sclerosus/Planus Using the Vulvar Quality of Life Index

Background Vulvovaginal diseases are under-reported and there is limited research on the nature of these conditions, the prevalence, and their impact patient on experience. Current estimates suggest 1 in 6 people with vulvas experience undiagnosed and untreated vulvovaginal discomfort over their lifetime. This may result from patient experiences of shame and stigma, lack of provider familiarity, or misunderstanding about these treatable conditions. Two of these conditions are vulvodynia and lichen sclerosus/lichen planus (LS/LP). Vulvodynia is a neuropathic pain condition and estimated to have a prevalence of 8% in the United States. LS/LP are chronic inflammatory and scarring disorders with a diagnosed prevalence of 0.05% in the United States, which is likely an underestimate. Quality of life is a comprehensive method of evaluating physical and psychosexual aspects of vulvar disease. The Vulvar Quality of Life Index (VQLI) is a 15 question survey scored out of 45 with lower scores indicating lower quality of life. It has been validated to assess individual health and treatment response. This study aimed to better understand of how the quality of life differs for patients with LS/LP and vulvodynia compared to controls and how it changes over time with treatment. Methods We are conducting a prospective cohort study using a baseline and follow-up surveys with the VQLI. Participants include adults in three groups: individuals with LS/LP, individuals with vulvodynia, and a control group without vulvar conditions (n=90). All participants completed an initial standardized questionnaire assessing vulvar quality of life. A follow-up survey was conducted five months later to evaluate changes over time. Comparative analyses were performed between groups to assess differences in baseline and follow-up outcomes. Results Preliminary results include 51 participants: n=16 (control), n=23 (LS/LP), and n=12 (vulvodynia), with follow-up data from n=11, n=10, and n=4, respectively. Mean total scores differed significantly by group (ANOVA p=2.26×10⁷). Post hoc testing showed the greatest mean difference between vulvodynia and control, with additional significant differences between LS/LP and control and between vulvodynia and LS/LP. Conclusion These findings demonstrate that vulvodynia and LS/LP severely impact quality of life compared to controls. As the study progresses, further data will clarify which variables most affect quality of life in vulvovaginal diseases. This may guide targeted counseling and follow-up. Treatment success may also be evaluated by its impact on quality of life.