4 Review Questions When Vulvar Lichen Planus Keeps Hurting

If sitting through dinner or thinking about sex now brings pain into the conversation, say that during your review. You can describe what you have stopped doing without having to soften the account.

Four questions to bring

1. Which areas are affected? Vulvar and vaginal involvement can occur, and scarring can narrow the vaginal opening. Ask the clinician to explain the examination findings and where each prescribed treatment belongs.¹
2. What is the maintenance plan? Treatment may continue intermittently after an initial course. Ask for your own application schedule, review date and instructions for a flare; do not copy another person’s schedule.¹
3. Could something else be adding to the pain? Infections can complicate erosive lichen planus. Ask whether new discharge or a change in symptoms needs an examination before changing treatment.¹
4. Which changes need an earlier appointment? A new enlarging lump or an ulcer with thickened edges needs assessment because cancer can occur in affected tissue. Do not wait for the routine review to report a concerning change.¹

Bring the instructions you have been following

Take the names of your medicines and the directions you were given. Tell the clinician which parts you could not follow or did not understand. Ask them to write the next steps in a form you can use at home.

Make a separate note of the effect on sitting, urination, intimacy or sleep. Choose your own words, including “I have been avoiding this because it hurts.” Ask what can be done about that specific difficulty.

Down There, Decoded includes a Down-There Log and an appointment script. Use them to organize your symptoms and the questions you want to say aloud. See the book.