Objective: To evaluate the quality of sexual life in patients with genital lichen sclerosus (LS) recruited in a trial aimed to assess the efficacy of innovative surgical treatments. Design and Method: The Index of Sexual Satisfaction (ISS) questionnaire was used. The Brief Pain Inventory (BPI) was also used to assess the level of pain/discomfort and the grade of interference of LS in daily activities, social relationships, happiness, mood and sleeping. Patients were evaluated at baseline, 4,12, and 24 weeks after treatment. Results: From May 2014 to December 2015, 74 heterosexual patients (52 men, 70.3%, median age 52, IQR: 37-68; 22 women, 29.7%, median age 59.2, IQR: 42-73) with genital LS were evaluated. Fifty-nine patients (79.7%) were sexually active; among these, 45 (76.3%) were in a stable sexual partnership. Overall, 56 patients (75.7%) reported a high degree of genital pain/discomfort, particularly the female patients (18/22, 81.8%), and measurable interferences in selected wellbeing dimensions, such as mood balancing and social relationships. Overall, 49 patients (66.2%) had a current/history of secondary sexual disorders after the onset of LS; dyspareunia (32/49, 59.1%) and desire disorders (8/49, 16.3%) were reported; vulvodinia (5/22, 22.7%), and erectile dysfunction (4/32, 12.5%) were also experienced. Over two-thirds of the sexually active patients who were in a stable partnership (31/45, 68.9%) declared a decrease in the number and quality of sexual intercourses per month. Conclusions: LS affects dramatically the quality of sexual life and secondary sexual disorders are very frequent among LS patients. Thus, a sexological support is needed for this population.