Sex with Lichen Sclerosus?

Hello, P. My heart goes out to you. I also had LS as a teen, but I'm 61, so the diagnosis was never made. I first had sex when I was 19 and it always stung afterward. I don't think I used a mirror until a few years in. Then I started complaining of a crack in my perineum. I had a very unsympathetic husband who expected sex very frequently. I had a lot of yeast infections, but now looking back some of them were probably LS flares.

You may be young enough for the cortisone cream to work and give you many flare-free periods. My main advice is try to make your partner understand that you have fragile flesh, so excessive of friction isn't good. What you don't want is to soldier on and wind up with scarring that erases the architecture of your clitoris and vulva. At your age you can prevent that happening. I've read posts by young women who use local anesthetics so they can have sex without pain. This sounds to me like a good way to allow damage to accumulate.

Looking back I know I had periods of years when the LS was dormant and other periods of lots of cracking. I had atrophy in my late thirties that reversed so I had great sex during my mid-forties. LS got very bad around menopause.

So, I hope you can benefit from having a sense of how it can go. We women who have it all our lives are rare. It's mostly little girls and post-menopausal women.

You know you have LS when you can't imagine how prostitutes can survive such frequent intercourse.

A sex life is certainly manageable with LS, and it would be important not to let fear of pain take hold as it can obviously lead to muscle spasm or vaginismus which would make things worse. It is important to treat your vulva well and follow the Royal College of Obstetricians and Gynaecologists guidelines and advice on care of the vulva (link at the bottom of patient.info leaflet), and then use lots of lubricant (Yes oil -based great for every day external use, and water based for internal use). Remember LS only affects the outer vulval tissues and not the vagina itself, and foreplay is important to optimise natural lubrication which should be good if you are young. If you use Dermovate as per the RCOG guidelines my gynaecologist says most women can manage well but don't stop treatment and use at least twice a week or you'll be back at square one. The Femmax vaginal dilator set has been invaluable to me as it allows you to practice muscle relaxation, and then when you come to intercourse you are less fearful and able to practice relaxation. They also allow you to be confident that your vagina can accept the erect penis, and can prevent narrowing through scarring. I had a Fenton's procedure as i was postmenopausal and didn't realise the narrowing was caused by LS rather than the menopause, and since then I use the dilators regular and my sex life has never been as good.