Does Vulvar Lichen Sclerosus Affect the Bladder?

Introduction

Getting a vulvar lichen sclerosus (VLS) diagnosis can be hard. It can feel both validating and terrifying. After a diagnosis, opening up your laptop and getting to Googling is not uncommon. Perhaps you join an online support group to help you learn more. However, amidst all this learning, you start to wonder about VLS and its connection to other symptoms you experience. For example, some folks want to know if there’s a connection between VLS and various autoimmune conditions. Others want to know if VLS can affect your gastrointestinal tract. Another common connection-based question we hear and see a lot is, “Does vulvar lichen sclerosus affect the bladder?”. If you’ve ever wondered about that, this is the post for you! We address this question and share what you need to know on the topic of bladder health and VLS.

*This post is evidence-based; I draw on the medical literature to share what you need to know about vulvar lichen sclerosus and the bladder. 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 the Bladder and What Are Examples of Bladder Health Issues

First things first, what is the bladder, anyway? The bladder is a stretchy, balloon-like organ located inside your lower abdomen. The bladder’s job is to store urine in the body until your body is ready to release it.

When you eat or drink, your body processes the liquids and produces waste, which eventually turns into urine. The bladder, being composed of stretchy, elastic tissues expand to hold urine in the body until you are ready to go pee. When you pee, the pelvic floor muscles around the bladder contract, moving urine from the bladder through the urethra. The urethra is a tube-like structure that acts as a passageway for urine to leave the body. Both the urethra and bladder are part of the urinary system and play an important role in overall bladder health.

Examples of Bladder Health Issues

Let’s talk about bladder health issues, as this term is an umbrella for different conditions affecting the bladder. Some examples include (but are not limited to):

1. Interstitial Cystitis (IC) or Painful Bladder Syndrome: A chronic condition causing pelvic pain, urinary urgency, and frequency.
2. Overactive Bladder (OAB): Characterized by a sudden, strong urge to urinate, often resulting in leakage (urge incontinence).
3. Bladder Prolapse: Weakening of the pelvic floor muscles can lead to the bladder dropping into the vaginal space, causing discomfort and incontinence.
4. Urinary Incontinence: The loss of bladder control, which can occur during activities like laughing, sneezing, or exercising.
5. Neurogenic Bladder: Dysfunction due to nerve damage, often associated with conditions like diabetes or spinal cord injuries, leading to issues with bladder emptying.

Does Vulvar Lichen Sclerosus Affect the Bladder – The Short Answer

If you have VLS and if you have/are experiencing bladder-related issues, you may be wondering, “Does vulvar lichen sclerosus affect the bladder? Can it be causing my symptoms?”.

The short answer is that VLS does not affect the bladder. VLS affects the vulva, which is the external genitalia, including the labia majora and minora, clitoral hood and glans, vestibule, urethral opening, vaginal opening, and perineum. It can also affect the skin around the anus. If you want to learn more about vulvar anatomy, click here.

As far as we know, VLS does not directly affect any internal organs, such as the bladder. I (Jaclyn) could not find any scientific research showing a direct causal role between LS and the bladder such that LS causes changes to the bladder (i.e., sclerosis), which ten leads to pelvic floor dysfunction. However, it’s always possible this could change with more research.

Does Vulvar Lichen Sclerosus Affect the Bladder – The Long Answer

OK. So that’s the short answer. But the reality is that this is a complex question, and some nuance needs to be highlighted.

I (Jaclyn) am of the belief that VLS may indirectly affect the bladder. Let’s elaborate.

First, people with VLS–especially those who have been living with symptoms for over 6+ months–may develop a secondary condition called overactive pelvic floor (aka tense pelvic floor muscles). See the video at the end of this section to learn more.

Second, pelvic floor muscles play an important role in bladder and urinary health.

If you have tense pelvic floor muscles or muscles that are in spasm, this can lead to several bladder-related issues, such as:

1. Urinary Urgency and Frequency: Tense pelvic floor muscles can create a constant urge to urinate. This urge can have you running to the bathroom frequently.
2. Incomplete Emptying: Tight pelvic floor muscles may obstruct the normal flow of urine, leading to a feeling of incomplete emptying of the bladder after urination. For example, you may pee but feel like not all of the pee came out.
3. Difficulty Initiating Urination: Tension in the pelvic floor can make it hard to start to pee.
4. Overactive Bladder (OAB): Persistent muscle tension can contribute to an overactive bladder, where the bladder contracts involuntarily, causing a sudden, strong urge to urinate (this list is not exhaustive).

Thus, it seems there could be this kind of indirect connection, but it’s a few steps removed–i.e., VLS can lead to overactive pelvic floor muscles/pelvic floor dysfunction. Overactive pelvic floor/pelvic floor dysfunction can in some cases lead to bladder issues. Of course, if they are connected, we need a lot more research in this area to tie all the pieces together.

Learn more about how VLS can lead to an overactive pelvic floor and how this can affect the pelvic floor organs like the bladder and pain with sex in this video we did with Dr. Mukta Chauhan.

What to Do If You Are Having Bladder-Related Symptoms

If you have VLS and are experiencing bladder-related symptoms/health concerns, it is important to talk to a healthcare provider. Your first point of contact may be a primary care physician or general practitioner, who may refer you to a gynecologist, urologist, or urogynecologist. These specialists can run tests, diagnose, and provide a treatment plan for the bladder condition in question.

Another good healthcare provider to see is a pelvic floor physical therapist. Pelvic floor physical therapy is usually involved in cases involving bladder issues. You could technically start by getting assessed by a physical therapist if your doctor isn’t available or if the specialist has a long wait time. However, bear in mind that pelvic floor physical therapists are limited in their ability to run tests, issue imaging (e.g., MRI, CT scan), and cannot prescribe medication.

Combining physical therapy with a good specialist can be incredibly helpful. If your healthcare provider suspects tense pelvic floor muscles to be causing or contributing to your bladder-related problems, pelvic floor physical therapy can teach you how to relax your nervous system and pelvic floor muscles. They can also provide an individualized care/treatment plan for your bladder issues.

Conclusion

In sum, even though VLS doesn’t directly impact the bladder, you might be having bladder issues because of tense pelvic floor muscles, which can happen as a result of dealing with VLS. If you are dealing with bladder-related symptoms, it’s important to discuss this with your healthcare provider and advocate for a diagnosis and proper treatment to manage this condition, in addition to VLS.

Let us know if you have bladder-related issues in the comments, what kind of healthcare providers you have seen for this, and what they have said in the comments below.

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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:

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