Women attending a dermatologic vulvar clinic were asked to reply by mail to an anonymous questionnaire asking simple questions about sexual function and pregnancy following the development of lichen sclerosus. Additional comments were invited from respondents. The majority of women of all ages reported that lichen sclerosus had a detrimental effect on sexual function, with problems including dyspareunia, apareunia and difficulty achieving orgasm. The symptoms may relate to continuing inflammatory disease as well as to anatomic changes and scarring from long-standing active disease. Disease-suppressing therapy should be instituted at the earliest opportunity, and surgery to reverse the effects of scarring should be considered.