Sir,

Vulvar lichen sclerosus is a chronic inflammatory skin condition, most common in postmenopausal women, characterized by intense itching (pruritus), skin whitening, and thinning in the genital area. Untreated, it can cause pain, severe tissue scarring, fusing of the labia, and increased cancer risk, and trivially speaking a noticeable increase of libido,like nymphomania [1–5].

Here the key symptoms of vulvar lichen sclerosus:

Intense Vulvar Itching: Often worse at night, this is the most common symptom.

Skin Changes: White, shiny, and thin spots or patches (atrophy) appear on the skin, which may become fragile and easily bruised.

Pain and Discomfort: Burning, soreness, or chronic pain in the vulvar area.

Dyspareunia: Painful intercourse due to narrowing of the vaginal opening or skin fragility.

Fissures and Erosions: Cracks in the skin, particularly around the anus or in the posterior commissure, which can bleed.

Structural Changes (Scarring): In advanced or untreated cases, the tissue becomes scarred, causing the labia minora and clitoris to shrink or fuse.

Urinary and Defecation Issues: Painful urination (dysuria) or discomfort during bowel movements if the anal area is affected.

Gynaecologists do recommend:

It is important to manage this condition early to prevent permanent architectural changes to the vulva and potential development of squamous cell carcinoma.

Now it is self evident that two of the majos culprits are:

Dyspnaeuria and Nymphomania. Besides all the other symptoms.

Authors made up his mind to combat these two concerns owing two dramatic strategies following the oral route and ant the topical one, directly externally and internally the vulva.

Generally to treat chronic pelvic pain and inflammation the vegetal remedies, that work by lowering the inflammatory markers or balancing oestrogen levels, this a brief digest very useful.

Curcumin: thanks to anti inflammatory properties that may help reduce pain, inhibiting the growth of endometrial cells.

Ginger: that acts as a natural analgesic

Chamomile: because contains chrysin, that inhibits dratically endometrial cells

Chrysin is retrievable in Oroxylon indicum:

Oroxylum indicum is a species of flowering plant in the monotypic genus Oroxylum in the family Bignoniaceae [6].

It is commonly called Indian trumpet tree, oroxylum,Indian trumpet flower,broken bones,scythe tree, tree of Damocles [4] or midnight horror. It can reach a height of 18 metres (59 ft). Various segments of the tree are used in traditional medicine.

The plant is used by the Kirat, Sunuwar, Rai, Limbu, Yakha, Tamang in Nepal, the Thai in Thailand and the Lao in Laos.

In the Himalayas, people hang sculptures or garlands made from O. indicum (Skr. shyonaka) seeds from the roof of their homes in belief they provide protection [7].

It is a plant with edible leaves, flower buds, pods and stems.

The large young pods, known as Lin mai or Lin fa in Loei, are eaten especially in Thailand and Laos. They are first grilled over charcoal fire and then the inner tender seeds are usually scraped and eaten along with lap.

Known as karongkandai among the Bodos of north east India, its flowers and fruit are eaten as a bitter side dish with rice. Its fruit are eaten as a side dish and water of boiled leave and bark as traditional medicine in Mizoram. It is known in Mizoram as Archangkawm. It is often prepared with fermented or dried fish and believed by them to have medicinal uses. The pods also eaten by Chakma people in Chittagong hill tracts of Bangladesh and India. Its called “Hona Gulo” in Chakma language.

The plant is used as food by the Karen people. The flower buds are boiled and pickled. The young pods are cut open raw and the tender seeds inside are used in various local dishes.

We could affirm that Oroxylon is a tropical Bignonia, as here in Occidental countries.

In this report an infusion made with Midnite horror fresh bark is used and its result are amazing.

To moisture this extract the best way is to mix 50% with honey to spread inside the vagina and on the internal labia.

This is the ointment that should be spread intimally.

Orally, the A considered all the plants that help to combat nymphomania (disbalance of the ratio (testosterone/oestrogen), and so:

Vitex agnus-castus that suppress sexual desire, affecting prolactin and testosterone levels.

Licorice: fresh root disminish testosterone levels in women

Spearmint: that reveals anti-androgenic properties inhibiting free testosterone levels in blood

White Peony: Paeniflorin reduces testosterone levels

Hops that reduces drastically the potential oestrogenic effects, by sedating the causes at hypothalamic niveau.

Root beer and alcohol free beer are richest in hops, and are really innocuous for human health.

This is the probable schedule or programme to combatVLS in post-menopausal women:

Twice a day two pints of root beer or alcohol free one (trade mark is not important)

Three times a day application of the topical mead made by 50% of Bignonia bark infusion and honey.

21 days of treatment are sufficent to observe a good restitutio ad integrum (no itching, no sexual behavioral excesses, no endometrial cells growth).

REFERENCES

1.  Damiani L, Quadros M, Posser V, Minotto R, Boff AL. Zoon vulvitis. An Bras Dermatol. 2017;92(5 Suppl 1):166-8.

2.  Goje O, Munoz JL. Vulvovaginitis:Find the cause to treat it:Cleve Clin J Med. 2017;84:215-24.

3.  Kalmi N, Baybay H, Choukri S, Douhi Z, Elloudi S, Soughi M, et al. Dermoscopic features of vulvar lichen sclerosus and their correlation with disease duration. Our Dermatol Online. 2024;15:361-4.

4.  Kalmi N, Baybay H, Choukri S, Douhi Z, Elloudi S, Soughi M, et al. Vulvar lichen sclerosus in female children. Our Dermatol Online. 2024;15:253-6.

5.  Dassouli R, BayBay H, Kalmi N, Joutei KT, Douhi Z, Elloudi S, et al. Dermoscopic features of vulvar sclerosus and atrophic lichen:About 52 cases. Our Dermatol Online. 2022;13:e9.

6.  Chaudhary AK, Singh V, Chaudhary AK. A review on the taxonomy, ethnobotany, chemistry and pharmacology of oroxylum indicum vent. Indian J Pharmaceut Scien. 2011;73:483–90.

7.  India Biodiversity Portal –Oroxylum indicum (L.) Kurz.