Lichen planus in the genital area can present with a variety of symptoms. The most common include intense itching, burning sensations, and pain during intercourse (dyspareunia). Patients may also notice white, lacy patches on the vulva, or erosive lesions that can cause significant discomfort. In severe cases, scarring and narrowing of the vaginal opening can occur, leading to complications like sexual dysfunction and difficulties in performing gynecological examinations.