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Sensitive Support: SLUCare Vulvar and Vaginal Disorders Center


SLUCare Urogynecologists Dr. Cherie LeFevre and Dr. Andrew Steele

SLUCare Urogynecologists Dr. Cherie LeFevre and Dr. Andrew Steele

When you have a health problem involving a discreet area of your body, it can be difficult to get the care you need simply because the condition is tough to discuss. SLUCare physicians understand the delicacy of such subjects, and they work to establish a comfort level so patients feel at ease speaking freely.

St. Louisan Kristina Franke, 45, understands the situation well. She had been struggling with vulvar dystrophy, a type of autoimmune skin condition that causes itching, scarring, discomfort, urinary problems and painful intercourse. She says it was frustrating and embarrassing, and it was interfering with her relationship with her husband. Hoping for a solution, she made an appointment with Dr. Cherie LeFevre, director of the SLUCare Vulvar and Vaginal Disorders Specialty Center.

Franke says she had endured long waits for doctors’ appointments in the past, but the SLUCare team understood the urgency of her case and worked her into the schedule quickly. She appreciated that LeFevre sensed her concerns right away and offered reassurance that she would be well cared for. After a thorough evaluation, Franke went to St. Luke’s Hospital for a vulvar reconstruction procedure with SLUCare gynecologic surgeon Dr. Andrew Steele, who also practices at SSM Health St. Mary’s Hospital along with LeFevre. Now, Franke says she feels much more comfortable and confident.

Even though it can be an embarrassing subject, they make me feel comfortable and supported, and they are always accessible when I have questions.”

SLUCare patient Kristina Franke

“The whole medical team has been amazing and compassionate,” she says. “Dr. LeFevre explained that this was a rare skin disease not caused by anything I had done, and she carefully outlined the surgery. All of my SLUCare doctors are patient and knowledgeable, and their follow-up has been very responsive and kind. Even though it can be an embarrassing subject, they make me feel comfortable and supported, and they are always accessible when I have questions.”

She notes that when she worked with other medical providers in the past, there was never a resolution, but the SLUCare team had her on the right path within a day. “And when I arrive for an appointment, I never sit in the waiting room for more than 5 minutes,” she says. “Other patients have told me that they drive in from two or three hours away to see SLUCare physicians. I appreciate the fact that the doctors have weekly meetings to talk about how to best serve their patients. They really take a team approach, which covers all of the bases.”

LeFevre explains that with an autoimmune condition like Franke’s, the body actually attacks its own tissues for reasons that are not yet fully understood. “Vulvar dystrophy usually happens in postmenopausal women, but younger patients can get it as well,” she says. “Specifically, Kristina had lichen planus and lichen sclerosus, which cause the itching, pain and other uncomfortable symptoms she was experiencing. She was understandably upset because she had been suffering for about three years. Originally, she couldn’t even get a regular Pap smear because there was so much vaginal narrowing and scarring. We receive many referrals of women with complex issues like this, and we have the knowledge and experience to help them manage their conditions and return to a good quality of life.”

Franke’s follow-up care includes steroids to reduce her body’s autoimmune response and stretching procedures to keep scar tissue from reforming. The condition requires regular at-home management, but the results are worth it, she says. “I feel lucky to have found such great doctors in my hometown,” she notes. “They are highly educated, and they really listen to what is going on with me. Whenever we need to make treatment alterations, they always do what is best for me.”

Steele says that the SLUCare medical team’s collaborative approach means a wealth of resources for patients like Franke who have sensitive, complicated issues. “Other problems such as bladder leakage and prolapse go hand-in-hand with vaginal and vulvar conditions, and many women have skin irritation and frequent yeast infections that may be caused or worsened by urinary incontinence,” he says. “If you don’t deal with all of the patient’s issues together, she may not get better. Our urogynecology division includes fellowship-trained doctors who can address vaginal and uterine prolapse, incontinence and other bladder disorders, and Dr. LeFevre and Dr. Susan Hoffstetter are experts in vulvar and vaginal infections and inflammatory conditions. We are able to work very closely with one another to get to the heart of a patient’s issues.”

SLUCare Physician Group provides knowledgeable, compassionate care and resources for women with urologic and gynecologic conditions. For more information, call 314-977-7455 or visit

This article originally appeared in Town & Style, November 18, 2019.

By: Julia M. Johnson