Why does lichen sclerosus cause pain during sex?

Lichen sclerosus changes the skin around the vulva and the entrance to the vagina. Inflammation can cause soreness and tiny cracks, while healing may leave the skin tighter and less flexible. The vaginal opening can narrow when scarring affects the surrounding tissue. Friction then causes burning, tearing, or pain during penetration, and discomfort may continue afterwards. Pain can also make the pelvic floor tighten, adding another layer of aching or difficulty with penetration.

Arrange an assessment with a clinician familiar with vulval skin conditions. Prescribed anti-inflammatory treatment can calm the underlying inflammation and help protect the skin. During sex, stop if there is pain or tearing, use a generous lubricant, and choose activities that do not stretch sore tissue. Do not apply perfumed washes or unprescribed creams to the area, as they may worsen irritation.

Seek medical advice for new or worsening pain, repeated splits, bleeding after sex, a sore that does not heal, or a new thickened or changing area. Prompt review is particularly important when symptoms persist despite treatment, because the skin may need examination and adjustment of care.

Ask whether the condition is affecting the vaginal opening, how to use prescribed treatment, and whether scarring or pelvic-floor tension is contributing. Ask what lubricant and skin-care products are suitable for you.