When to worry about pain during sex with lichen sclerosus

Lichen sclerosus can make vulval skin fragile, itchy, sore, and less able to stretch. Friction may cause burning, splits, or pain at entry. Scarring can change the shape of the vulval tissues and make penetration increasingly uncomfortable.

Pain may also be related to infection, dryness, pelvic floor muscle tightening, or another skin condition. A flare and a separate problem can feel similar, so a persistent change deserves examination.

Do not push through pain. Avoid fragranced products, wash gently, use any prescribed ointment exactly as directed, and consider a suitable lubricant to reduce friction. Record itching, cracks, bleeding, new skin changes, and whether treatment is helping.

Arrange review if sex remains painful, cracks recur, the skin is changing, or treatment is difficult to use. A clinician can check healing, scarring, infection, and whether the treatment plan needs adjustment.

Seek prompt assessment for a sore, lump, ulcer, thickened area, or skin change that does not heal, as well as repeated bleeding or rapidly increasing pain. Seek urgent help for severe pain, heavy bleeding, fever, or difficulty passing urine.

Ask whether the pain comes from active inflammation, fissures, scarring, infection, or pelvic floor tension. Ask how to use prescribed treatment, whether follow-up is needed, and which new skin changes should be examined without delay.