Aunt Vadge: are these cuts from my lichen planus?

Hi there Aunt Vadge, 

Last week my boyfriend and I had sex for five hours. My labia was bleeding, sore and stinging afterwards, unexpectedly. I didn’t think anything of it, but it didn’t stop bleeding so I went to the emergency room, and they said I had tears/sores in my vagina and on my labia. I had a swab for herpes, which came back negative, however I do have lichen planus. I went through menopause when I was about 30. The other day, we had sex for five hours again, and the same thing happened. 

I’m still scared it’s herpes, even though I’ve had a blood test too. Can it be herpes? 

Age: 48
Country/Area: USA

Dear Stinging,

I think it’s safe to say you do not have herpes. Negative blood tests should be relied upon when it comes to herpes, because your body creates antibodies that are easy to find. A false-negative is uncommon, and the symptoms you describe don’t really sound like herpes. It would be prudent to investigate the other causes of your cuts and tears, namely your lichen planus and the effects on your vagina. If it isn’t your LP, then there is a reason why your vulvar and vaginal tissue is not able to tolerate sex the way it used to.

There seems to be, at least in the short-term, an easy solution to your conundrum, which is to try to have sex for less than five hours at a time! Your vagina is clearly not coping. Sex for long periods of time that causes abrasions on your vaginal walls and vulva may be triggering off your lichen planus symptoms, which you would be wise to avoid.

It may be time for you to look into atrophic vaginitis, since this can cause easy tearing and vaginal tissue that isn’t as robust as it used to be. At 48, you would normally be hitting menopause about now anyway, and other hormones do change even if you have been menopausal for 17 years. That means you went through either an early unnatural menopause at age 30 for some reason. You have likely been on hormone replacements all this time, but these hormone treatments are not magic and age will catch up with you. Maybe your hormones need adjusting.

This is not to say that your body shouldn’t be able to cope with five hours of sex, but I think it’s safe to say that any vagina being penetrated for five hours is going to need a rescue mission afterwards. What is clear is that your vaginal and vulvar tissue is breaking down quicker than it should or used to, but the reason for this is unclear.

You have a few options available to you, but first I would suggest getting a proper run-down from your gynaecologist regarding what your vaginal cells are up to. If this is your lichen planus flaring up, you need to be really careful because LP can leave your vagina unusable over time. Causing inflammation and tissue damage could be the perfect storm. Knowing what your cells are doing, and if it is LP, allows you to treat your vagina with kindness and care, and get treatments should you need them. If it’s not LP, then understanding what it is would be useful – it’s not herpes or an STI, but something is going on and you need to find out what that is.

Write anytime.

Warmest regards,
Aunt Vadge

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