International Journal of Gynecology & Obstetrics 46 (1994) 53-56 Topical testosterone 1. 1 in the treatment of vulvar ncnen sclerosus Article M. Sideri”, M. Origoni*b, L. Spinaci”, A. Ferrarib “1st Department of Obstetrics and Gynecology, ‘L. Mangiagalli’ Institute, Milan, Italy b6th Department of Obstetrics and Gynecology, University of Milan School of Medicine, ‘H. San Raffaele’ Scientific Institute. Via Oigettina 60. 20132 Milan, Italy Received 10 April 1994; revision received 22 April 1994; accepted 22 April 1994 Abstract Objectives: Comparison between 2% testosterone propionate and petrolatum ointment in the treatment of vulvar lichen sclerosus in a randomized, double-blind, controlled clinical study. Methods: Fifty-eight donsecutive patients with histologically confirmed vulvar lichen sclerosus were enrolled. They underwent a l-year period of topical treatment with either medication, with clinical evaluations of symptoms and gross appearance at 2-monih intervals, followed by histological evaluation at the end of the treatment period. Statistical analysis was performed according to the chi- squared test and the Student-Newman-Keuls test. Results: A substantial improvement in symptoms was achieved in 20 (66.6%)patients in the testosterone group and in 21 (75%) patients in the placebo group. No statistical differences were observed between the two groups. Gross changes were observed in a few cases and no case demonstrated histologic modifications. Conclusions: Petrolatum ointment is as effective as 2% testosterone in the treatment of vulvar lichen sclerosus. Keywords: Vulva; Vulvar dystrophy; Lichen sclerosus; Testosterone; Topical treatment 1. Introduction Vulvar lichen sclerosus is a vulvar dystrophy of unknown etiology. It has a chronic clinical course characterized by intense pruritus. Untreated, the condition is progressive and results in dissolution of the labia minora, ecchymoses, and contracture * Corresponding author, Fax: (392) 26413592. of the introitus with subsequent dyspareunia. It occurs at any age, but preferentially affects post- menopausal women. The traditional form of ther- apy for vulvar lichen sclerosus was once vulvectomy. Most clinicians used to consider that this method not only relieved symptoms but also provided pro- phylaxis against the subsequent development of vulvar carcinoma. Multiple studies, however, have demonstrated that the condition has no or minimal 0020-7292/94/%07.00 0 1994 International Federation of Gynecology and Obstetrics SSDI 0020-7292(94)02134-K