Painful Sex (Dyspareunia)

What Is Dyspareunia

Dyspareunia or Painful sex is pain that is associated with sexual intercourse. It can occur just before, during or after sex.

According to the American College of Obstetricians and Gynaecologists, this is a common condition that nearly 3 out of 4 women will experience some time in their lives.

The pain can either be felt around the external genital region, around the outer vagina or vulva, or it can be felt internally deeper in around the uterus or lower abdomen.

For some women, the pain is only a temporary problem, for others, it is a long-term problem.

Dyspareunia can have a negative emotional and psychological impact on a woman’s relationship and can put a strain on their personal life and relationship.

Hence, it is important to seek help early and address this as soon as possible.

Types of Dyspareunia

Dyspareunia can be broadly classified into 2 categories – Superficial and Deep. The location of the pain determines the type of dyspareunia that you are suffering from.

Types of Dyspareunia

Superficial Dyspareunia

This refers to pain felt at the outer region of the vagina during initial penetration. ​​This can include feeling a tearing or burning sensation, which can also sometimes be localized to one particular spot.

Deep Dyspareunia

This refers to pain that is ​​often felt deep in the vagina or may sometimes even present as a deep discomfort in the pelvic region.

Women experiencing deep dyspareunia usually have no issues with the initial attempt of penetration, but usually feel the pain or discomfort after full penetration is achieved.

Causes Of Dyspareunia

The causes of dyspareunia vary depending on the type of dyspareunia you experience. It is important to consult an experienced women’s health doctor for a thorough evaluation of your condition to understand the root cause of the problem.

Female reproductive health concept

Causes of Superficial Dyspareunia:

Lack Of Or Reduced Vaginal Lubrication

This is one of the most common causes of dyspareunia which affects a significant number of women.

​​Some common factors that cause reduced vaginal lubrication include:

Factors such as breastfeeding can also reduce estrogen levels which reduces a woman’s sexual desire. This decreases vaginal lubrication which leads to pain during sex. Certain medications such as antidepressants or other drugs can also affect this.

Vaginismus is a condition that is caused by involuntary clenching or contracting of the vaginal walls and muscles, hence making penetration or any attempt at penetration painful or difficult.

This condition is also extremely common in women. Women suffering from vaginismus usually have pain and difficulty initiating penetration, making sexual intercourse impossible.

Vaginal Atrophy

This is a common problem amongst post menopausal women. Vaginal atrophy is caused by severe vaginal dryness due to the low estrogen levels after menopause.

This causes sex to become painful.

Injury, Trauma or Irritation

Injury or trauma can be due to factors such as pelvis surgery or recent childbirth. It is well known that women who have recently gave birth, particularly those who went through a difficult delivery process, complicated vaginal tears or poor healing will be predisposed to experiencing pain during sex.

Vaginal infections can present as pain during sex as well. This is due to inflammation of the surrounding tissues. It is particularly important for women to ensure that this is not due to a sexually transmitted infection.

Causes of Deep Dyspareunia:


Endometriosis is a condition whereby the endometrium (inner lining of the uterus) grows outside of the uterus. This results in inflammation of the surrounding tissues, which can lead to pain during sexual intercourse.

Cervicitis (Inflammation of the Cervix)

Cervicitis is commonly caused by inflammation associated with infections, particularly sexually transmitted infections like chlamydia, gonorrhea or trichomonas. Inflammation leads to pain during sex as well as possible bleeding after sex as well.

Ovarian Cysts and Fibroids

Painful sex may also be a sign of more serious gynaecological causes such as ovarian cysts or fibroids. Hence it is important to get checked early.

Pelvic Inflammatory Disease

Pelvic inflammatory disease is caused by chronic inflammation and adhesions internally around the pelvic organs. This is often due to untreated STDs like Chlamydia and Gonorrhea.

Ectopic Pregnancy

Ectopic pregnancy is a pregnancy that occurs outside the womb. This can also cause pain during sex. This can be potentially life threatening if not diagnosed and treated in time.

What To Expect When You See A Doctor For Dyspareunia?

There can be so many different causes of dyspareunia, and it is best to consult an experienced women’s health doctor to determine the exact cause of it.

Your doctor will need to take a thorough history, including a sexual history and also perform a detailed physical examination.

Necessary investigations will also be performed to allow accurate diagnosis of the cause of dyspareunia.

Accurate and proper diagnosis will go a long way in guiding your doctor to providing the correct treatment to solve your problem as quickly as possible.

Think you need a Consultation?

Treatment of Dyspareunia

Treatments depend on the underlying cause contributing to pain during intercourse. This may range from simple measures such as adequate lubrication during intercourse, to medications or surgery if required.

It is not only important to address the underlying medical condition, but also address the psychological aspect of dyspareunia.

Women suffering from dyspareunia, particularly the long standing ones, can often have strained relationships with their partners or have emotional or psychological stresses that may require referral to an appropriate counsellor.

At Ezra Clinic, we provide a safe environment for women to seek help for any sexual issues they may be facing. We specialize in treating female sexual health conditions like Dyspareunia.

Frequently Asked Questions

How long does it take to recover from dyspareunia?
The recovery time for dyspareunia varies depending on the underlying cause for the pain you feel during sex. The good news is that when the underlying condition is correctly diagnosed, appropriate treatment can resolve this issue effectively and quickly.
Are there things a woman can do to help with pain during sex?

If you are experiencing pain during sex, it is most important to consult a women’s health clinic to get evaluated for your symptoms.

Some other tips that can help include:

  • Using water based lubricants before and during sex
  • Make time for sex. Set aside a time when neither you nor your partner is tired or anxious.
  • Have an open and honest conversation with your partner. Tell your partner where and when you feel pain, as well as what you are comfortable with.
  • Try other forms of intimacy that do not cause pain
Where can I seek help if I am experiencing painful sex?
Painful sex can lead to physical discomfort as well as negative emotional and psychological distress for women. Many women may feel embarrassed to seek help if they are going through this. It is important to understand that dyspareunia is easily treatable when the root cause is identified.

You can visit a specialized Women’s Health Clinic like Ezra Clinic. We aim to provide a safe and comfortable space for women to seek help for their intimate issues to restore their confidence and wellness.


Dr Michelle Chia

Medical Director

After graduating from the National University of Singapore, Dr Michelle's journey allowed her to train in Women's Health and Aesthetic Medicine. Her experience has led her to be featured on multiple media platforms including Radio Stations and prominent Magazines like Her World, Women's Weekly and CLEO. Her work has also received recognition both locally and internationally in several Medical Conferences.

Ezra Clinic is a Women’s Health, Wellness and Aesthetic Clinic that is conveniently located at the top floor of Royal Square Medical Suites in Novena, Singapore’s Medical Health Hub.

Helmed by Dr Michelle Chia, Ezra Clinic is your chosen one stop clinic for all your Women’s Health and Wellness needs.


    101 Irrawaddy Road #21-09, Royal Square Medical Centre, Singapore 329565

    Phone number


    WeCreativez WhatsApp Support
    Welcome to Ezra!
    Hi, how can I help you?