{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:26:21Z","timestamp":1792718781308,"version":"4.5.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T00:00:00Z","timestamp":1448928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Women with lichen sclerosus (LS) may experience (superficial) dyspareunia or the inability to have vaginal intercourse due to painful fissures and narrowing of the vaginal introitus. A surgical procedure may contribute to the relief of these sexual pain problems. It is unknown what motives women have to undergo surgery in order to regain the ability to have sexual intercourse. Such knowledge can offer important insights that are indispensable when discussing the option of vulvar surgery with patients with LS and might prevent potential patient dissatisfaction. This study\u2019s purpose is to examine why women with LS decide to undergo vulvar surgery in order to restore intercourse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Nineteen women with anogenital LS participated in audiotaped qualitative individual interviews, in which their motives for undergoing vulvar surgery to restore intercourse were explored retrospectively. Interview data were analyzed using the constant comparative method.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Three main motives for wanting to undergo surgery in order to restore intercourse were found. These were the desire to be a \u201cnormal\u201d woman, the desire to sexually satisfy the male partner, and the desire to regain the experience of intimacy and sexual enjoyment. Another reason for surgery was to reduce daily life LS symptoms. The sexual pain complaints prevented the women from living up to their norms about heterosexuality and gender roles. Being unable to have intercourse led women to feel inadequate as a woman and as a sexual partner.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Women with LS may opt for surgery to restore their identity as a \u201cnormal\u201d woman and sexual partner, to regain the experience of coital intimacy, and to be less bothered by LS symptoms in daily life. The present findings point to the importance of a thorough couple-based sexual history in which women\u2019s motives for and expectations of vulvar surgery will be explored in order to facilitate a good decision and to increase treatment satisfaction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1111\/jsm.13052","type":"journal-article","created":{"date-parts":[[2015,11,27]],"date-time":"2015-11-27T09:54:40Z","timestamp":1448618080000},"page":"2462-2473","source":"Crossref","is-referenced-by-count":25,"title":["Motives for Vulvar Surgery of Women with Lichen Sclerosus"],"prefix":"10.1093","volume":"12","author":[{"given":"Marieke","family":"Brauer","sequence":"first","affiliation":[{"name":"Department of Sexology and Psychosomatic Obstetrics and Gynecology \u00a0 , Amsterdam , The Netherlands"},{"name":"Academic Medical Center \u00a0 , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rik","family":"van Lunsen","sequence":"additional","affiliation":[{"name":"Department of Sexology and Psychosomatic Obstetrics and Gynecology \u00a0 , Amsterdam , The Netherlands"},{"name":"Academic Medical Center \u00a0 , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matth\u00e9","family":"Burger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u00a0 , Amsterdam , The Netherlands"},{"name":"Academic Medical Center \u00a0 , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Laan","sequence":"additional","affiliation":[{"name":"Department of Sexology and Psychosomatic Obstetrics and Gynecology \u00a0 , Amsterdam , The Netherlands"},{"name":"Academic Medical Center \u00a0 , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,12,1]]},"reference":[{"key":"2023010718583818000_bb0010","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s40257-012-0006-4","article-title":"Diagnosis and treatment of lichen sclerosus","volume":"14","author":"Fistarol","year":"2013","journal-title":"Am J Clin Dermatol"},{"key":"2023010718583818000_bb0015","first-page":"477","article-title":"Prevalence of vulvar lichen sclerosus in a general gynecology practice","volume":"50","author":"Goldstein","year":"2005","journal-title":"J Reprod Med"},{"key":"2023010718583818000_bb0020","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1111\/j.1365-2133.2010.09997.x","article-title":"British Association of Dermatologists\u2019 guidelines for the management of lichen sclerosus","volume":"163","author":"Neill","year":"2010","journal-title":"Br J Dermatol"},{"key":"2023010718583818000_bb0025","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1111\/j.1542-2011.2012.00175.x","article-title":"Recognition and management of vulvar dermatologic conditions: Lichen sclerosus, lichen planus, and lichen simplex chronicus","volume":"57","author":"Thorstensen","year":"2012","journal-title":"J Midwifery Womens Health"},{"key":"2023010718583818000_bb0030","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/j.1745-7599.2012.00715.x","article-title":"Silent no more! The lived experiences of women with lichen sclerosis","volume":"24","author":"Wehbe-Alamah","year":"2012","journal-title":"J Am Acad Nurse Pract"},{"key":"2023010718583818000_bb0035","first-page":"351","article-title":"Effect of lichen sclerosus on sexual function and parturition","volume":"40","author":"Dalziel","year":"1995","journal-title":"J Reprod Med"},{"key":"2023010718583818000_bb0040","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/j.1743-6109.2007.00703.x","article-title":"The vulvar dermatoses","volume":"5","author":"Burrows","year":"2008","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0045","doi-asserted-by":"crossref","first-page":"279","DOI":"10.3109\/0167482X.2010.507890","article-title":"The effect of vulvar lichen sclerosus on quality of life and sexual functioning","volume":"31","author":"van de Nieuwenhof","year":"2010","journal-title":"J Psychosom Obstet Gynaecol"},{"key":"2023010718583818000_bb0050","doi-asserted-by":"crossref","first-page":"3395","DOI":"10.1111\/j.1743-6109.2009.01505.x","article-title":"Sexual functions and depressive symptoms after photodynamic therapy for vulvar lichen sclerosus in postmenopausal women from the Upper Silesian Region of Poland","volume":"6","author":"Skrzypulec","year":"2009","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0055","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1089\/jwh.2014.4805","article-title":"The impact of vulvar lichen sclerosus on sexual dysfunction","volume":"23","author":"Haefner","year":"2014","journal-title":"J Womens Health"},{"key":"2023010718583818000_bb0060","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/j.1743-6109.2010.02077.x","article-title":"The treatment of vulvar lichen sclerosus and female sexual dysfunction","volume":"8","author":"Burrows","year":"2011","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0065","first-page":"22","article-title":"Dyspareunia: A symptom of female sexual dysfunction","volume":"8","author":"Spano","year":"1975","journal-title":"Can Nurse"},{"key":"2023010718583818000_bb0070","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/BF03020230","article-title":"The hyperactive pelvic floor syndrome (HPFS): Psychosomatic and psycho-sexual aspects of hyperactive pelvic floor disorders with comorbidity of urogynecological, gastrointestial and sexual symptomatology","volume":"32","author":"Van Lunsen","year":"2002","journal-title":"Acta Endoscopica"},{"key":"2023010718583818000_bb0075","first-page":"325","article-title":"Lichen sclerosus en seks. [Lichen Sclerosus and sexuality]","volume":"124","author":"Burger","year":"2011","journal-title":"NTOG"},{"key":"2023010718583818000_bb0080","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/j.det.2010.07.006","article-title":"Lichen sclerosus","volume":"28","author":"Murphy","year":"2010","journal-title":"Dermatol Clin"},{"key":"2023010718583818000_bb0085","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1111\/j.1529-8019.2010.01355.x","article-title":"Vulval lichen sclerosus and lichen planus","volume":"23","author":"McPherson","year":"2010","journal-title":"Dermatol Ther"},{"key":"2023010718583818000_bb0090","first-page":"750","article-title":"Treatment of dyspareunia and vaginal outlet distortions by perineoplasty","volume":"57","author":"Woodruff","year":"1981","journal-title":"Obstet Gynecol"},{"key":"2023010718583818000_bb0095","first-page":"277","article-title":"Surgical procedures in benign vulval disease","volume-title":"The vulva","author":"Paniel","year":"1999","edition":"2nd edition"},{"key":"2023010718583818000_bb0100","article-title":"The Hite report","author":"Hite","year":"1976"},{"key":"2023010718583818000_bb0105","article-title":"The case of the female orgasm: Bias in the science of evolution","author":"Lloyd","year":"2005"},{"key":"2023010718583818000_bb0110","first-page":"335","article-title":"Sex, pleasure and dyspareunia in liberal Northern Europe","volume-title":"The cultural context of sexual pleasure and problems: Psychotherapy with diverse clients","author":"van Lunsen","year":"2013"},{"key":"2023010718583818000_bb0115","author":"QSR International Pty. Ltd","year":"2006"},{"key":"2023010718583818000_bb0120","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1177\/1525822X04266540","article-title":"Reliability in coding open-ended data: Lessons learned from HIV behavioral research","volume":"16","author":"Hruschka","year":"2004","journal-title":"Field Methods"},{"key":"2023010718583818000_bb0125","article-title":"Analysis in qualitative research","author":"Boeije","year":"2010"},{"key":"2023010718583818000_bb0130","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1007\/s10508-007-9204-1","article-title":"\u201cIf Sex Hurts, Am I Still a Woman?\u201d The subjective experience of vulvodynia in hetero-sexual women","volume":"37","author":"Ayling","year":"2008","journal-title":"Arch Sex Behav"},{"key":"2023010718583818000_bb0135","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1057\/palgrave.fr.9400262","article-title":"Unreal women: Sex, gender, identity and the lived experience of vulvar pain","volume":"82","author":"Kaler","year":"2006","journal-title":"Fem Rev"},{"key":"2023010718583818000_bb0140","first-page":"556","article-title":"Between a rock and a hard place","volume":"23","author":"Horvath","year":"2010","journal-title":"Psychologist"},{"key":"2023010718583818000_bb0145","article-title":"Understanding depression: Feminist social constructionist approaches","author":"Stoppard","year":"2000"},{"key":"2023010718583818000_bb0150","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/136346099002001003","article-title":"Interruptus coitus: Heterosexuals accounting for intercourse","volume":"2","author":"Gavey","year":"1999","journal-title":"Sexualities"},{"key":"2023010718583818000_bb0155","first-page":"92","article-title":"Who\u2019s zoomin\u2019 who? A feminist, queer content analysis of \u201cinterdisciplinary\u201d human sexuality textbooks","volume":"22","author":"Myerson","year":"2007","journal-title":"Hypatia"},{"key":"2023010718583818000_bb0160","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1080\/00224499.2012.753982","article-title":"\u201cIt Feels So Good It Almost Hurts\u201d: Young adults\u2019 experiences of orgasm and sexual pleasure","volume":"51","author":"Opperman","year":"2014","journal-title":"J Sex Res"},{"key":"2023010718583818000_bb0165","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.jadohealth.2008.02.011","article-title":"Why do young women continue to have sexual intercourse despite pain?","volume":"43","author":"Elmerstig","year":"2008","journal-title":"J Adolesc Health"},{"key":"2023010718583818000_bb0170","doi-asserted-by":"crossref","first-page":"82","DOI":"10.3109\/0167482X.2013.793665","article-title":"Prioritizing the partner\u2019s enjoyment: A population-based study on young Swedish women with experience of pain during vaginal intercourse","volume":"34","author":"Elmerstig","year":"2013","journal-title":"J Psychosom Obstet Gynaecol"},{"key":"2023010718583818000_bb0175","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1007\/s10508-012-9903-0","article-title":"A qualitative study of heterosexual women\u2019s attempts to renegotiate sexual relationships in the context of severe sexual problems","volume":"41","author":"Hinchliff","year":"2012","journal-title":"Arch Sex Behav"},{"key":"2023010718583818000_bb0180","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1080\/14681994.2013.844785","article-title":"Living with genito-pelvic pain\/penetration disorder in a heterosexual relationship: An interpretative phenomenological analysis of interviews with eight women","volume":"28","author":"Svedhem","year":"2013","journal-title":"Sex Relat Ther"},{"key":"2023010718583818000_bb0185","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1080\/0092623X.2014.931315","article-title":"The differential associations of communication & love in heterosexual, lesbian and bisexual women\u2019s perceptions and experiences of chronic vulvar and pelvic pain","volume":"41","author":"Blair","year":"2015","journal-title":"J Sex Marital Ther"},{"key":"2023010718583818000_bb0190","article-title":"The science\/fiction of sex: Feminist deconstruction and vocabularies of heterosex","author":"Potts","year":"2002"},{"key":"2023010718583818000_bb0195","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1080\/00224499.2012.688227","article-title":"The medicalization of women\u2019s sexual pain","volume":"49","author":"Farrel","year":"2012","journal-title":"J Sex Res"},{"key":"2023010718583818000_bb0200","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1111\/j.1743-6109.2007.00705.x","article-title":"Psychosexual characteristics of vestibulodynia couples: Partner solicitousness and hostility are associated with pain","volume":"5","author":"Desrosiers","year":"2008","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0205","doi-asserted-by":"crossref","first-page":"3715","DOI":"10.1111\/j.1743-6109.2010.01957.x","article-title":"Woman and partner-perceived partner responses predict pain and sexual satisfaction in provoked vestibulodynia (PVD) couples","volume":"7","author":"Rosen","year":"2010","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0210","doi-asserted-by":"crossref","first-page":"2351","DOI":"10.1111\/j.1743-6109.2012.02851.x","article-title":"Harmful or helpful: Perceived solicitous and facilitative partner responses differentially predict pain and sexual satisfaction in women with provoked vestibulodynia","volume":"9","author":"Rosen","year":"2012","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0215","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s10508-012-9905-y","article-title":"Provoked vestibulodynia: Mediators of the associations between partner responses, pain, and sexual satisfaction","volume":"42","author":"Rosen","year":"2013","journal-title":"Arch Sex Behav"},{"key":"2023010718583818000_bb0220","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1111\/jsm.12210","article-title":"Sexual and relationship intimacy among women with provoked vestibulodynia and their partners: Associations with sexual satisfaction, sexual function, and pain self-efficacy","volume":"10","author":"Bois","year":"2013","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0225","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/j.1743-6109.2009.01365.x","article-title":"The role of anxiety in vaginismus: A case-control study","volume":"7","author":"Watts","year":"2010","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0230","doi-asserted-by":"publisher","first-page":"3051","DOI":"10.1111\/jsm.12697","article-title":"Predictors of task-persistent and fear-avoiding behaviors in women with sexual pain disorders","volume":"11","author":"Brauer","year":"2014","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0235","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1080\/009262300278641","article-title":"The female sexual response: A different model","volume":"26","author":"Basson","year":"2000","journal-title":"J Sex Marital Ther"},{"key":"2023010718583818000_bb0240","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1111\/j.1743-6109.2008.00815.x","article-title":"Appetitive and aversive classical conditioning of female sexual response","volume":"5","author":"Both","year":"2008","journal-title":"J Sex Med"},{"key":"2023010718583818000_bb0245","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1080\/00926230152051806","article-title":"Ideal female sexual function","volume":"27","author":"Everaerd","year":"2001","journal-title":"J Sex Marital Ther"},{"key":"2023010718583818000_bb0250","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1177\/0959353508095533","article-title":"What makes women experience desire?","volume":"18","author":"Laan","year":"2008","journal-title":"Fem Psychol"},{"key":"2023010718583818000_bb0255","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1080\/00224490902747768","article-title":"An integrative theoretical framework for understanding sexual motivation, arousal, and behavior","volume":"46","author":"Toates","year":"2009","journal-title":"J Sex Res"},{"key":"2023010718583818000_bb0260","article-title":"Treatment evaluation of vulvar surgery in women with lichen sclerosus: A qualitative study","author":"Brauer"},{"key":"2023010718583818000_bb0265","article-title":"Seksuele gezondheid in Nederland","author":"Bakker","year":"2006"},{"key":"2023010718583818000_bb0270","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/j.1365-2648.2004.03207.x","article-title":"Methodological rigour within a qualitative framework","volume":"48","author":"Tobin","year":"2004","journal-title":"J Adv Nurs"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609516300194?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609516300194?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/12\/12\/2462\/48476643\/jsm_12_12_2462.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/12\/12\/2462\/48476643\/jsm_12_12_2462.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T14:44:00Z","timestamp":1675953840000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/12\/12\/2462\/6966905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,1]]},"references-count":53,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2015,12,1]]},"published-print":{"date-parts":[[2015,12,1]]}},"URL":"https:\/\/doi.org\/10.1111\/jsm.13052","relation":{},"ISSN":["1743-6109","1743-6095"],"issn-type":[{"value":"1743-6109","type":"electronic"},{"value":"1743-6095","type":"print"}],"subject":[],"published-other":{"date-parts":[[2015,12]]},"published":{"date-parts":[[2015,12,1]]}}}