What Are The First Symptoms Of Dyspareunia & How Do You Test For It?

The hallmark symptom of dyspareunia is pain during sexual intercourse that typically occurs at the mouth of the vagina or deep in the pelvis.1, 2

Dyspareunia patients may experience mild to stabbing pain similar to menstrual cramps.3

Medical evaluation of dyspareunia involves a thorough medical history, pelvic exam, and other tests.4

Dyspareunia is painful sex that affects 8 –22% of women at some point during their lives. It affects women’s quality of life and places a significant financial burden on women. A systematic review of studies of dyspareunia, conducted by the World Health Organization shows that this is one of the most common complaints in gynecologic practice.

The pain can be sensed in a woman’s private organs or deep inside her pelvis. The condition is more common in women than men however it is a treatable condition.

What Are The First Symptoms Of Dyspareunia?

  • Dyspareunia can occur for several aspects that vary from underlying problems to emotional reasons. Common physical causes involve
  • Vagina dryness when the estrogen levels are low. This typically occurs during menopause, childbirth, breastfeeding, and old age.
  • Cracks and ulcers in the skin on your vulva can cause painful sex
  • vulvodynia affects female genitalia can make sex extremely painful burning or irritated.
  • Pelvic inflammatory disease can be passed through vaginal, oral, and anal causing pelvic pain that might last for months or years.
  • Uterine fibroids are often stressful and cause pressure in your uterus especially during sexual intercourse
  • Certain medical treatments like radiation and chemotherapy and surgeries may lead to painful intercourses.

In addition to all these, a history of sexual abuse, intermittent stress, and emotional issues can cause irritation or pain.1, 2

The hallmark symptom of dyspareunia is pain during sexual intercourse that typically occurs at the mouth of the vagina or deep in the pelvis. Most women report that they have a feeling of something heavy is thrust into them. When you have painful or discomforting intercourse, you may experience the following

  • deep pain at the opening of the vagina
  • intense pain during penetration or inserting of the penis.
  • Dyspareunia patients may experience mild to stabbing pain similar to menstrual cramps
  • severe tightening of the vaginal muscles during thrusting
  • Throbbing pain, lasting hours after intercourse.3

How Do You Test For Dyspareunia?

Your healthcare provider can diagnose the underlying cause of pain during intercourse. This is typically done through thorough medical history, pelvic exam, and other tests.

Thorough Medical History: This is one of the powerful diagnostic technology to gather information about the person’s health. Your healthcare provider may evaluate your pain condition, when your pain began and how your pain feels like. The doctor differentiates between primary and secondary dyspareunia based on whether the woman has ever had a history of productive sexual encounters.

Pelvic Exam- When you have stabbing pain during intercourse, your doctor may suggest for a pelvic examination. A speculum is the most common instrument used to perform a visual examination of your pelvis. It provides some clues about certain kinds of pain particularly when you have recurrent pain.

During the diagnosis, your doctor may examine your vagina, cervix, fallopian tubes, bladder, and rectum to spot signs of infection. This is often carried out during a regular physical exam, pregnancy, and painful sex.

Cotton Swab Test – Your doctor may recommend for cotton swab test to determine the urethral mobility. During the test, the cotton-swab is applied to a multitude of locations of the vulvar vestibule to help explain your dyspareunia.4


  1. “Painful Intercourse (Dyspareunia).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 7 Feb. 2020, www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967.
  2. Staff, Familydoctor.org Editorial. “Dyspareunia – Painful Sex.” Familydoctor.org, 8 Jan. 2020, familydoctor.org/condition/dyspareunia/.
  3. Publishing, Harvard Health. “Painful Sexual Intercourse (Dyspareunia).” Harvard Health, www.health.harvard.edu/a_to_z/painful-sexual-intercourse-dyspareunia-a-to-z.
  4. “Sexual Health: Female Pain During Sex (Dyspareunia) Diagnosis and Tests.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/12325-sexual-health-female-pain-during-sex-dyspareunia/diagnosis-and-tests.

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