Women with genital lichen sclerosus (GLS) report sexual dissatisfaction despite adequate medical treatment. The present study examined the moderating role of romantic attachment on the relationship between genital self-image and sexual satisfaction in a sample of 55 women with GLS. Their mean age was 42.12 years (SD = 13.45). Data was collected via an online questionnaire. Hierarchical multiple regression models were used to test the moderation hypothesis. Our results show that genital self-image is a significant positive predictor and romantic attachment dimensions (anxiety and avoidance) are significant negative predictors of sexual satisfaction, controlling for GLS symptoms. Contrary to our hypothesis, the interaction between the two variables was not significant, indicating no moderating role of romantic attachment. Clinical interventions should focus on female genital self-image and romantic attachment in women with GLS to address sexual dissatisfaction.