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Does Stress Cause Vulvar Lichen Sclerosus?

Does Stress Cause Vulvar Lichen Sclerosus?


A common experience in processing a vulvar lichen sclerosus (VLS) diagnosis is understanding what happened. “What went wrong?”, “Why did this happen to me?” and “What caused this?” are common questions we here in our community. I know I (Jaclyn) have definitely gone down the ‘cause’ rabbit hole, trying to figure out just what exactly happened to my body to result in VLS. Today, we will discuss a topic that most people can relate to–stress. Specifically, we will address the question, “Does stress cause vulvar lichen sclerosus?” as this is one of the top questions we hear during our virtual meetups, Instagram DMs, and emails. First, we discuss what stress is and then address whether stress causes VLS. Second, we address the flip side of this question, “Can VLS cause stress?”. Finally, we share different ways to help manage stress and develop greater stress resilience.

*This post is evidence-based; I draw on the medical literature to share what you need to know about vulvar lichen sclerosus and stress. Importantly, what I share is my interpretation of the science and data.

**If you found this post helpful, we’d love your support to continue providing important education like this. Make a donation today, volunteer with us, or share our posts in your support groups.

What is Stress

The American Institute of Stress defines stress as the feeling of being overwhelmed or unable to cope with mental or emotional pressure in response to a situation or life circumstances. In other words, stress is the body's way of reacting to a challenge or demand. It's a natural response that can happen when you feel threatened, overwhelmed, or under pressure. Stress can manifest both in the body (e.g., tense upper back, clenching your jaw) and mentally (e.g., feeling irritable and on edge).

Image of a person with tan skin working at a desk looking incredibly stress from a demanding job with tight deadlines.

The concept of stress is rather subjective in that what is stressful to one person may be enjoyable or motivating to another. 

A number of things can cause you to feel stressed. For example, you may feel stressed about your performance at work or at school, acting as a caregiver, traumatic events such as the COVID-19 pandemic, a natural disaster such as a hurricane, a divorce, or your finances.

What Happens to the Brain/Body When You Experience Stress

A situation or life circumstance–whether real or imagined–can trigger a part of the brain called the cerebral cortex (an area that plays a role in attention, perception, etc.). The cerebral cortex then sends an ‘alarm bell’ signal to the hypothalamus, the brain area responsible for keeping your body's internal environment balanced and in check. The ‘alarm bell’ signal to the hypothalamus is basically saying, “Red alert, red alert, we are in danger!”. To keep us safe, the hypothalamus brings the sympathetic nervous system online. 

The sympathetic nervous system is your body's “fight or flight” response team. Imagine it as an alert superhero ready to tackle emergencies. When faced with danger or stress, this system kicks into action, increasing your heart rate, dilating your pupils, tensing up your muscles, and pumping adrenaline. It readies you for action, like gearing up for a quick escape or facing a challenge head-on. 

This is good and sometimes necessary in certain situations–e.g., if there is a tornado and you have to bolt as fast as your legs can run to safety. However, turning on your sympathetic nervous system for too long can lead to long-term negative effects on the mind and body. For example, it can disrupt and cause digestive issues, impact sexual function, and impact immunological and inflammatory systems.

Chronic Stress and the Body

In some instances, stress is short-lived. For example, if you have a work deadline, you may feel stressed until the deadline, but once you submit, the stress fades away. 

However, stress can also be chronic–meaning it impacts you long-term. Chronic stress can build up in two ways. First, small stressors can build up over time and overwhelm the nervous system, keeping the body stuck in sympathetic mode if you do not have the tools to manage and cope with stress properly. Second, big (or multiple big) stressful life events like the death of a family member, loss of a job and facing financial and food insecurity, or getting diagnosed with a chronic illness–can all lead to chronic stress.

So think about it this way.

Stress is an inevitable part of our lives. Most of us will have day-to-day stressors like raising a family, job stress, etc. But then add to that the stress of getting diagnosed with and needing to learn how to live with a chronic condition. Yeah, that’s a lot of stress. 

Graphic design image of two people hugging each other representing solidarity in the stress that comes with living with VLS.

Does Stress Cause Vulvar Lichen Sclerosus?

At the time I write this, there are no papers that definitively come out saying that stress causes VLS. The reality is that many complex and interacting factors, including stress, may cause VLS.

There have been a lot of advances in the last few years in VLS research. A lot more is known about the underlying mechanisms involved in VLS. However, there are still a lot of question marks and unknowns when it comes to a deep understanding of VLS. 

A paper by De Luca et al. (2023) outlines the process of VLS and how it progresses in the body. I’m unable to replicate images in published journals for copyright purposes. However, if you are interested in looking at Figure 1., it is a great illustration of how VLS progresses. 

Now, regarding causes, the authors note that a diverse set of factors may trigger VLS. Those factors include medications, hormones, infections, and trauma. To be clear, the authors do not fully know the details of these factors, just that they may be involved in VLS progression. You may notice that stress is not included. However, trauma is, and trauma/traumatic events can be a source of stress for many individuals. Therefore, it is possible that stress from trauma plays a role in causing VLS. 

Nonetheless, the picture is far from clear, and more research needs to be done to better understand the causal factors involved in VLS. The answer for now may be a cautious, it’s possible but not certain.

Can VLS Cause Stress?

Absolutely, it can. How people experience stress related to their VLS will, of course, vary, and some people may not experience it at all. However, for those that do, it can manifest as stress relating to managing multiple health appointments, excess anxiety, guilt, nervousness, rapid pulse/chest palpitations, worry of VLS getting worse, ruminating over sensations and symptoms, etc. You may feel more irritable and prone to snapping out of frustration or exhaustion.

Arnold et al. (2022) talk about the challenge of navigating a new life and learning to cope with a chronic illness diagnosis and the stress that comes with it. For example, having to keep track of different medications and topicals and modifying daily activities can cause stress.

The stress of my VLS diagnosis affected me deeply in the beginning. The stress of adapting my life to this new reality was completely overwhelming, especially since, at the time, I couldn’t find much information, resources, or support for VLS. I was an anxious mess. My heart rate felt constantly elevated as if it could burst through my chest. I had constant headaches, muscle spasms/tension, panic attacks, and experienced nervousness and irritability. Luckily, this stress slowly melted away and faded into the background the more I educated myself about VLS and the more I worked on practicing adapting coping skills.

Graphic design image of a doctor and an appointment chart, a person exhausted and collapsed in their chair with a bar of energy above their head reading "low", and medications (pills and ointments) to represent the stress of managing a chronic condition like vulvar lichen sclerosus.

When it comes to stress caused by living with VLS (and stress in general), it is important to adopt helpful coping strategies and work on fostering stress resilience. 

How to Manage Stress with VLS?

Here’s the thing. There is no perfect technique for managing stress. What works for one person may not work for another. The good news is that there are a number of ways to manage stress and foster greater stress resilience. 

Here are some options for managing stress and fostering greater stress resilience.

  • Stimulating your vagus nerveget my webinar (on sale now) to learn more about the role of stress, the nervous system, and how to stimulate your vagus nerve to foster stress resilience. Alternatively, you can Google different ways to activate your vagus nerve.
  • Good sleep/resting. Sleep and rest are important for overall health. Aim to get around 6-8 hours of sleep and practice good sleep hygiene if possible. Good sleep hygiene includes trying to sleep consistently, minimizing screen time, and doing something relaxing such as listening to a meditation or using a lavender spray on your pillow.
  • Exercising/moving your body. Exercising has many benefits, including strengthening your immune system, improving bone health, reducing blood pressure, giving you a natural ‘feel good’ feeling, and, you know it, stress relief. Worried about exercising with VLS? Not sure what to do? Check out my videos on working with VLS, including a demo of a seated workout routine and a standing workout routine.
  • Meditation. Meditation is a great way to decompress, stimulate your vagus nerve, and build strong stress resilience. There are several free guided meditations on YouTube, or you can try apps like Calm and Headspace. I find Michael Sealy’s meditation videos to be very helpful. 

More stress management and stress resilience tools:

  • Therapy and counseling. Some find cognitive behavior therapy (CBT) to be helpful. CBT involves challenging and changing negative thoughts (e.g., thinking you’ll never be happy and experience fun again) and behaviors (e.g., avoiding any/all social events (Rector, 2020).
  • Prioritize yourself. Take a break just to disconnect and restore your energy. For example, set an alarm or date in your calendar for “me time” once a week. The length of time depends on your schedule, but try to aim for 15 minutes. During that time, turn off your phone, shut down your computer, and do something soothing and relaxing, like taking a bath or doing a restorative yoga practice.
  • Connect with a support group. A community can be healing, and some folks find support groups to help with managing stress and mental health issues that can accompany VLS.
  • Acupuncture. A meta-analysis of acupuncture for stress and anxiety by Yang et al. (2021) found that acupuncture–a traditional Chinese healing practice that involves small needles being inserted into specific points on the body depending on the ailment requiring healing–can be a beneficial therapy for managing stress and anxiety.
  • Jaclyn's Vagus Nerve, Stress, and VLS webinar – get it here at 50% off.

Of course, you can mix and match these. This list is not exhaustive; many other great ways to manage stress exist. Do what works for you!

Conclusion–Does Stress Cause Vulvar Lichen Sclerosus? The Bottom Line

In sum, stress may play a role in causing vulvar lichen sclerosus; however, this connection is not fully understood. Living with VLS can cause chronic stress. It is helpful to manage stress and foster stress resilience to help cope with chronic stress.

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Reach Out To Me

Whether you are debating booking a support call with me, have a quick question, or want to share something related to my content, I can be reached via:

Email: Jaclyn@lostlabia.com

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Support Resources

FREE Lichen Sclerosus Virtual Meetup hosted by myself and Kathy of Lichen Sclerosus Podcast – sign up here.

Feel free to book a 1:1 call with me if you struggle with grief and emotions. Simply click this link to learn more about lichen sclerosus peer support calls.

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For a more detailed list of free and paid support resources, check out my LS resources page here.

Sources Cited

American Institute of Health

Arnold, S., Fernando, S., & Rees, S. (2022). Living with vulval lichen sclerosus: a qualitative interview study. British Journal of Dermatology, 187(6), 909–918. https://doi.org/10.1111/bjd.21777

De Luca, D. A., Papara, C., Vorobyev, A., Staiger, H., Bieber, K., Thaçi, D., & Ludwig, R. J. (2023). Lichen sclerosus: The 2023 update. Frontiers in Medicine, 10, 1106318. https://doi.org/10.3389/fmed.2023.1106318

Rector, N. A. (2010). Cognitive-behavioral therapy: An information guide. Centre for Addiction and Mental Health.

Yang, X., Yang, N., Huang, F., Ren, S., & Li, Z. (2021). Effectiveness of acupuncture on anxiety disorder: a systematic review and meta-analysis of randomized controlled trials. Annals of General Psychiatry, 20(1). https://doi.org/10.1186/s12991-021-00327-5

One Comment

  • Janet Shelly

    This is very interesting and timely for me. I have suffered with panic anxiety for nearly 40 years, it has not been an issue for me for the last 10 years, but suddenly a week ago it reappeared in my life, and I am struggling daily now. I have gone back to the practices I learned 10 years ago, but am having issues coping. I was diagnosed with LS 2 months ago and having issues getting this flare to settle down, in fact the last few days I notice the itching picking up again. The point is, I believe the stress factor goes both ways. Thank you for sharing this.

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