Understanding Lichen Sclerosis: What You Need to Know Lichen Sclerosis (LS) is a condition we see more often than people realise — yet many individuals go years without the right diagnosis. At Pelvic Health Melbourne, our goal is to make conversations about vulval, penile and anal health easy, accessible and stigma-free. Here’s a clear guide to what LS is, how it’s treated, and how pelvic health physiotherapy can support you. What Is Lichen Sclerosis (LS)? Lichen Sclerosis is a long-term inflammatory skin condition that typically affects the vulva, penis, or the skin around the anus. A few key facts: It’s not contagious. You can’t pass LS on to a partner. It may have a genetic or autoimmune link. People with other autoimmune conditions can be more prone to developing it. It’s more commonly diagnosed in people in their 40s and 50s, though it can occur at any age. Common Signs and Symptoms LS can look and feel different for everyone, but some of the most common symptoms include: Itching, burning or general soreness around the vulva, penis, or anus Skin changes, such as pale or white patches, areas that appear thickened or “crinkled,” or skin that becomes thin and fragile over time Dryness and loss of natural skin oils, leading to cracks, fissures, bruising or even blisters Possible scarring or narrowing of the vaginal or anal openings in long-standing vulval or anal LS In penile LS, symptoms often affect the foreskin and glans (head of penis) If any of these symptoms sound familiar — especially if they’ve been going on for a while — it’s worth discussing LS with your GP or pelvic health clinician. Typical Management & Treatment in Australia The good news: with early diagnosis and treatment, LS can be well managed and long-term complications can be reduced. Common treatments include: Topical steroid ointments or creams to reduce inflammation Topical oestrogen if thinning or hormone-related changes are present (for vulval LS) Gentle skin care routines to restore moisture and protect fragile skin Silicone-based lubricants for comfortable intimacy Vaginal dilators or vibrators to help maintain stretch and comfort if the vaginal entrance has narrowed Your GP or dermatologist will oversee the medical management — but pelvic health physio plays a big role too. How Pelvic Health Physio Can Help Our clinicians at Pelvic Health Melbourne are experienced in recognising LS and supporting you through the often-overlooked side effects of the condition. We can help with: Identifying symptoms early and guiding you to your GP for diagnosis and treatment Addressing secondary pain, such as burning or discomfort caused by pelvic floor overactivity Managing scarring or narrowing at the vaginal entrance using dilators, moisturises and tailored lubrication advice Supporting intimacy goals, helping reduce muscle tightness and improve comfort during sexual activity Easing nerve-related pelvic pain, which can develop from chronic irritation or inflammation Managing LS isn’t just about treating the skin — it’s about restoring comfort, confidence and quality of life. Why Awareness Matters LS is not extremely common, and some practitioners may only encounter it rarely. This means it can sometimes be overlooked or mistaken for recurrent thrush, eczema or dermatitis. Knowing the signs — and knowing to ask the question — can make a big difference. Early treatment helps: Control inflammation Prevent or reduce scarring Maintain skin health Improve long-term comfort and function If you suspect LS, trust your instincts and seek support. You're not alone — and there are effective treatments available. If you’d like guidance, reassurance, or help managing symptoms, our pelvic health physiotherapy team is here to support you every step of the way.

Period Pain: What Is Normal and When to Seek Help Many people experience discomfort or cramping during their period. It’s often dismissed as “just part of being a woman,” but not all period pain is normal. In fact, period pain (also called dysmenorrhoea) can vary widely in intensity and impact, and in some cases it may signal an underlying issue that deserves proper attention.  As pelvic health physiotherapists, we see many people who are unsure whether their pain is something they should live with, or whether there are strategies to help. The good news is: support is available. Why does period pain happen? Each month, the uterus contracts to help shed its lining. These contractions can temporarily reduce blood flow and irritate nearby nerves, leading to cramping sensations in the lower abdomen. Pain may also radiate to the lower back or thighs. For many, this pain is mild and lasts only 1–2 days at the start of the period. But for others, it can be more severe, long-lasting, and disruptive to daily life. When is period pain not normal? While some discomfort is expected, pain is not normal when it is: Severe, sharp, or ongoing beyond the first couple of days Preventing you from going to work, school, sport, or social activities Not improving with simple strategies like heat, stretching, or gentle exercise Associated with other symptoms, such as nausea, vomiting, bowel changes, heavy bleeding, or pain with intimacy If this sounds familiar, it may be worth seeking further support. In some cases, conditions such as endometriosis or adenomyosis can cause significant pelvic pain, and these are best managed with a team approach. How pelvic health physiotherapy can help? A pelvic health physiotherapist looks at how your muscles, posture, and movement patterns may be contributing to pain. Pain often leads to protective tension in the pelvic floor muscles, which can create a cycle of ongoing discomfort. Physiotherapy can help by: Assessing pelvic floor function: checking for muscle overactivity or tension that may be amplifying pain Teaching relaxation techniques: including breathing strategies, pelvic floor “drops,” and mindfulness-based approaches Prescribing gentle exercise and stretches: to ease cramping and improve circulation Lifestyle guidance: such as posture awareness, pacing strategies, and exercise modifications around your cycle Collaborating with your GP or gynaecologist: ensuring that if further investigation or medical treatment is needed, you have the right support Period pain is very common, but that doesn’t mean it should disrupt your quality of life or be brushed off as normal. If your periods are leaving you in bed, stopping you from enjoying daily activities, or not responding to simple strategies, it’s time to reach out for help. A pelvic health physiotherapist can work with you to reduce pelvic tension, support your body with movement and lifestyle strategies, and guide you towards further medical input if necessary. Pain is your body’s way of telling you something. Listening to it, and seeking the right support, is the first step towards feeling more in control of your cycle.

Perimenopause: The Chapter Before Menopause Perimenopause is the transition phase before menopause, when the ovaries gradually slow their production of the hormones oestrogen and progesterone. Unlike menopause, which is marked by the end of menstrual cycles, perimenopause is a shifting and fluctuating period of hormonal change. This stage can begin earlier than many women expect. While the average onset is in the mid-40s, some women experience signs in their late 30s. Perimenopause can last a few months, but for some, it stretches over several years — sometimes up to eight or more. Because the changes happen gradually, early signs are often missed or dismissed as “just stress” or “getting older.” Recognising these changes is the first step in managing them effectively. Common Signs and Symptoms Hot flushes and night sweats Sudden waves of heat, flushing of the skin, and sweating can appear during the day or interrupt sleep at night. These can range from mild to intense and may be triggered by factors such as stress, certain foods, or changes in room temperature. Sleep disturbances Falling asleep can become more difficult, and many women wake during the night without a clear reason. This can lead to fatigue and low energy during the day. Mood changes Shifts in mood, including irritability, anxiety, and sudden emotional reactions, can be linked to fluctuating hormones. For some, these changes can feel out of character and disruptive. Irregular periods Cycles may shorten, lengthen, or become heavier or lighter. Periods may also skip entirely before resuming again, adding to the unpredictability. Cognitive changes (brain fog) Some women report difficulty concentrating, forgetfulness, or losing their train of thought mid-sentence. These changes can be frustrating, especially in work or social situations. Changes in libido and vaginal health A decline in sexual desire, vaginal dryness, or discomfort during intimacy may occur due to reduced oestrogen levels. Physical changes Aches, joint stiffness, changes in skin texture, and pelvic floor symptoms such as urinary leaks, urgency, or a sensation of heaviness can develop. Why This Stage Matters Perimenopause is a natural stage of life, but it can have a significant impact on physical, emotional, and social wellbeing. Many women feel they have to “push through” without support, yet there are effective strategies to help. These may include: Adjusting exercise and nutrition to support hormonal health and bone strength. Learning pelvic floor exercises to address or prevent leaks and discomfort. Using medical treatments such as hormone replacement therapy (HRT) or other symptom-management options under guidance from a healthcare professional. Exploring lifestyle changes like stress management, consistent sleep routines, and reducing trigger foods. Tracking and Seeking Support One of the most useful steps you can take is to track your symptoms. Keeping a simple diary for two to three months can help identify patterns and make discussions with your GP or women’s health physiotherapist more productive. If symptoms are disrupting your daily life — whether that means poor sleep, ongoing discomfort, or emotional strain — professional help is available. The sooner support is sought, the smoother this transition can be. Perimenopause may be a natural phase, but with the right knowledge, tools, and care, it doesn’t have to be a time of uncertainty or struggle.