Pain during intercourse (dyspareunia) is recurring pain in the genitals or pelvis during or after sex. Pain at the entrance is often caused by dryness, infection, skin conditions, vulvodynia or tight pelvic floor muscles; deep pain may come from endometriosis, ovarian cysts, fibroids or infection. A pelvic exam and ultrasound usually identify the cause.
- Entry pain
- Dryness, infection, vulvodynia, vaginismus
- Deep pain
- Endometriosis, cysts, fibroids, PID
- Diagnosis
- Exam, swabs, transvaginal ultrasound
- Ultrasound
- Usually same day
- Treatment
- Depends on the cause
- Doctor
- Dr. Joonho Cho, OB-GYN specialist
Entry pain vs. deep pain
| Entry (superficial) pain | Deep pain | |
|---|---|---|
| Where | At the vaginal opening or vulva | Deep in the pelvis with deeper penetration |
| Feels like | Burning, stinging, tearing, tightness | Aching, sharp or cramping pain |
| Common causes | Dryness, yeast or other infection, vulvodynia, vaginismus, scar tissue | Endometriosis, ovarian cysts, fibroids, pelvic infection, adhesions |
| Key tests | Exam, swabs, touch-test mapping | Transvaginal ultrasound, STD tests |
| Read more | Vulvodynia | Endometriosis |
What causes painful sex?
- Dryness — not enough arousal time, breastfeeding, menopause, some contraceptives or medicines; see vaginal dryness.
- Infections — yeast, bacterial vaginosis, trichomoniasis, herpes, chlamydia or gonorrhea.
- Skin conditions — lichen sclerosus, eczema, irritation from soaps or condoms.
- Pelvic floor tension or vaginismus — muscles that tighten involuntarily.
- After childbirth — healing tears or episiotomy scars.
- Pelvic conditions — endometriosis, ovarian cysts, fibroids, pelvic inflammatory disease.
- Emotional factors — anxiety, past painful experiences or relationship stress.
- Pain at entry or deep inside
- Avoiding intimacy
- Previous treatments did not help
- Unsure whether it is infection or something else
- Cause identified with exam and ultrasound
- Treatment matched to the cause
- Self-care and pelvic floor guidance
- Aims for comfortable intimacy again
How is it diagnosed at Yoonho?
- Consultation in English Where and when it hurts, how long it has been happening, your cycle, births, contraception and any discharge or bleeding.
- Gentle examination Done at your pace, with a small speculum or none at all if needed. You can stop at any time.
- Swabs and STD tests To check for yeast, bacterial vaginosis and sexually transmitted infections, with results usually within days.
- Transvaginal ultrasound Usually the same day, to look for cysts, fibroids or signs of endometriosis — see pelvic ultrasound.
- Treatment plan Findings explained in plain English, with written instructions and English documents on request.
Treatment options
| Cause | Typical treatment |
|---|---|
| Dryness or menopause | Lubricants, moisturizers, local vaginal estrogen |
| Infection | Antifungal, antibiotic or antiviral treatment; partner treatment for STDs |
| Vaginismus or pelvic floor tension | Pelvic floor physiotherapy, dilators, counseling |
| Vulvodynia | Vulvar care, topical or nerve-pain medicines, physiotherapy |
| Scar tissue after birth | Massage, local treatment, or scar revision in selected cases |
| Endometriosis, cysts, fibroids | Medication or minimally invasive surgery |
Self-care while you are being treated
- Pause penetrative sex if it hurts; intimacy can continue in other ways.
- Use a water- or silicone-based lubricant generously.
- Allow more time for arousal before penetration.
- Try positions that let you control depth and pace.
- Avoid fragranced soaps, douches and wipes.
Cost and insurance
As a general guide, a consultation is about ₩50,000–100,000, and infection tests are about ₩30,000–100,000; a written estimate is given after consultation. Residents enrolled in Korea’s National Health Insurance (NHIS) are generally covered for medically necessary consultations and tests, while elective or aesthetic treatments are not. Read more about health insurance for foreigners at Korean clinics, or ask for an itemized receipt and English diagnosis for travel insurance claims.
Why international patients choose Yoonho
Frequently asked questions
Is it normal for sex to hurt sometimes?
Occasional mild discomfort can happen, for example with dryness. Pain that recurs or keeps you from sex is not something you need to accept and is worth checking.
Can pain during sex be a sign of an STD?
Yes. Chlamydia, gonorrhea, trichomoniasis and herpes can cause pain. STD testing is easy to add to your visit.
Why does sex hurt after giving birth?
Healing tissue, scars and low estrogen while breastfeeding are common causes. Most improve with time, lubricant and pelvic floor care; persistent pain should be examined.
Can endometriosis cause painful sex?
Yes. Deep pain during sex is a common symptom of endometriosis, particularly when it affects the area behind the uterus.
Can I be seen quickly as a foreigner in Seoul?
Walk-ins are welcome during opening hours, and ultrasound is usually available the same day. You can also book via WhatsApp or KakaoTalk.
OB-GYN Specialist · Ph.D. · Medical Director
M.D., M.Med. & Ph.D., Chung-Ang University · OB-GYN specialist training, Eulji University Medical Center · Member, Korean Society of Obstetrics and Gynecology
Last reviewed: . This page is for general information and does not replace an in-person consultation.
Talk to an English-speaking gynecologist
Yoonho Hospital · 304 Apgujeong-ro, Gangnam-gu, Seoul · Mon–Fri 9:00–18:00, Sat 9:00–13:00 · Walk-ins welcome.