Abstract Introduction While there is increasing interest in studying aspects of communication processes in sex research, the association between dyadic sexual communication and relationship and sexuality outcomes has not yet been examined in pre-menopausal women with dyspareunia. Aim To examine the associations between dyadic sexual communication and pain, sexual distress, sexual function and dyadic adjustment in women with self-reported dyspareunia and their male partners. Methods Pre-menopausal women (n = 38; M age = 24.92, SD = 6.12) with self-reported dyspareunia from a community sample and their partners (n = 38; M age = 26.71, SD = 6.59) completed an online survey. The Actor-Partner Interdependence Model was used in order to investigate both actor and partner effects. Main Outcome Measures Both members of the couple completed: (i) the Dyadic Sexual Communication Scale and (ii) the Dyadic Adjustment Scale; women also completed (iii) the Female Sexual Function Index, (iv) the Female Sexual Distress Scale, and (v) a Visual Analogue Scale on pain during intercourse; and men also completed (vi) the International Index of Erectile Functioning. Results Controlling for relationship duration, women's better dyadic sexual communication was significantly associated with their higher levels of sexual function (P = 0.028), lower levels of sexual distress (P = 0.003) and higher levels of dyadic adjustment (P = 0.005), but not with their pain or men's sexual function or dyadic adjustment. Controlling for relationship duration, men's better dyadic sexual communication was associated with their higher levels of dyadic adjustment (P = 0.027) but not with their sexual function, nor with women's sexual function or dyadic adjustment. Conclusions These findings contribute to the theoretical knowledge on interaction processes in couples with dyspareunia and suggest that it may be important to enhance open and direct communication about sexual matters in couples with dyspareunia.