Genito-Pelvic Pain/Penetrative
Disorder in Women

Sexual Wellness /

Genito-Pelvic Pain/Penetrative Disorder in Women

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What is Genito-Pelvic Pain/Penetrative Disorder in Women?

What is Genito-Pelvic Pain/Penetrative Disorder in Women?

Genito-Pelvic Pain/Penetrative Disorder (GPPPD) is a sexual dysfunction characterized by significant pain during attempted vaginal penetration, including during intercourse, pelvic examinations, or the use of tampons. The disorder involves both physical pain and psychological distress, which can impact sexual function and overall quality of life.

Classifications

Classifications

GPPPD is classified under the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) as a sexual dysfunction in women and is divided into:

  • Dyspareunia: Pain during or after sexual intercourse.

  • Vaginismus: Involuntary spasms of the pelvic floor muscles, leading to difficulty or inability to insert anything into the vagina.

  • Combined: The presence of both pain and involuntary muscle spasms.

Symptoms

Symptoms

Common symptoms of GPPPD include:

  • Pain during vaginal penetration, often described as sharp, burning, or aching.

  • Difficulty or inability to insert a tampon or undergo gynecological exams.

  • Emotional distress, anxiety, or fear surrounding sexual activity.

  • Tightness or muscle spasms in the pelvic region during sexual intercourse.

  • Painful intercourse that may occur at specific times or be constant.

Causes

Causes

Physical Causes:

  • Vaginal infections, such as yeast infections or sexually transmitted infections (STIs).

  • Endometriosis, pelvic inflammatory disease, or fibroids.

  • Scar tissue or adhesions from surgeries or childbirth.

  • Insufficient vaginal lubrication or hormonal imbalances (e.g., menopause)


Psychological Causes:

  • History of sexual trauma, abuse, or fear.

  • Anxiety, depression, or relationship issues.

  • Stress or negative attitudes towards sex.

Treatment

Treatment

Medical Treatments:

  • Topical anesthetics or lubricants to reduce pain.

  • Hormonal therapy, including estrogen or vaginal moisturizers, for those with menopausal changes.

  • Pain medications or antidepressants to manage associated pain or anxiety.

Physical therapy

  • Pelvic floor therapy to relax tight muscles and improve muscle function

  • Biofeedback or pelvic excerises to strengthen and relax the pelvic muscles

Psychological and Alternative Therapies

  • Cognitive-behavioral therapy (CBT) to address anxiety, fear, or trauma.

  • Sex therapy to address emotional, relational, or intimacy issues.

  • Mindfulness and relaxation techniques to reduce stress and improve sexual experiences.

When to see a Doctor?

When to see a Doctor?

Psychological and Alternative Therapies

There is discomfort that limits sexual activity or affects daily life.

There are signs of infections, such as unusual discharge, itching, or swelling.

There is a history of sexual trauma, or psychological distress related to sexual activity.

Difficulty achieving lubrication or maintaining sexual comfort persists, especially during menopause.

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