In this episode:

• Examine the vulva in menopause consultations
• Biopsy is important for diagnosis
• Differentiating vulval conditions
• Treatment with potent topical steroids
• Referral considerations

The questions answered in this podcast are listed below.
They were compiled by GPs and health professionals around Australia who attended Healthed’s face-to-face seminars.

1. Do you always examine the vulva in the menopause consult, or would you wait and see if the patient doesn’t have the expected response to vaginal oestrogen?
2. How do we differentiate between lichen sclerosus, lichen planus, or lichen simplex chronicus?
3. Do you think the itch of lichen sclerosus responds to vaginal oestrogen? Could you give this to a woman, and she’s going to get better, and you’ll never know that she had lichen sclerosus?
4. What treatments do you use, and for how long?
5. Can you take a punch biopsy from one site – the site that you think is perhaps the easiest to biopsy or looks the most affected?
6. Is a 3 mm punch biopsy big enough?
7. Do you have to pop a suture in?
8. How do you manage the care of that biopsy after you’ve done it?
9. Is referring to a dermatologist or gynaecologist better for biopsy?
10. Which steroids do you use, for how long, and what results do you expect?
11. How does a woman present with lichen planus?

Expert: Dr Terri Foran, Sexual Health Physician

Host: Dr Marita Long, GP and Medical Educator

Total time: 23 mins

Recommended resources:

• Vaginal atrophy and genitourinary symptoms of menopause – Your questions answered: Part 1 | Healthed