Lichen sclerosus is a vulvular pathology involving thinning of the epidermis with fibrosis/sclerosing dermis, most commonly presenting with skin fragility (paper-thin) in post-menopausal women (FA2020 p644)

The other answers do not fit:

• Candidal infection = itchyness and cottage cheese discharge; the excessive itching can lead to lichen sclerosus but would also be treated by the miconazole
• HPV = genital warts or cervical cancer
• Trichomoniasis = itchy with green smelly discharge, see organisms on microscopy
• Urethral prolapse = rare, painful, would not cause these symptoms and would cause swelling in urethral area