6 Tips to Reduce Vaginal Pain

Today we are going to discuss Genito-Pelvic Pain/Penetration Disorder, or GPPPD. It's a relatively new diagnostic category of female sexual dysfunction, first introduced in 2013.

GPPPD reflects the combination of two older categories of female sexual dysfunction, dyspareunia and vaginismus, into one entity. Dyspareunia is pelvic pain during or after sexual intercourse and vaginismus is an involuntary spasm of the musculature surrounding the vagina causing it to close, resulting in penetration being difficult, painful, or impossible.

It’s estimated that the prevalence of GPPPD is around 15% in North America, but some research supports higher estimates. It should be noted that many people don’t report their vaginal pain during intercourse. In fact, one study found that only about 51% told their partners about vaginal pain and that mild to moderate pain was unlikely to be enough to get them to speak up to their partners. However, even mild pain can disrupt sexual satisfaction and pleasure.

What are the symptoms of GPPPD?

The diagnostic criteria for GPPPD include persistent or recurrent difficulties with one (or more) of the following:

1. Vaginal penetration during intercourse.
2. Marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts.
3. Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration.
4. Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration.

Keep in mind that penetration can be sexual penetration like intercourse or finger stimulation or non-sexual like gynecological examinations or tampon insertion. A person may struggle in all situations or may notice difficulty in one area and not another. The pain can be more superficial (closer to the opening of the vagina) or deeper in the pelvic region. Some may find that the pain lingers after sexual intercourse is over. The pain in GPPPD can be described as “burning,” “shooting,” “cutting,” or “throbbing.” Some may note a sense of heat or irritation. These issues persist for 6 months or more.

For those who have deal with this situation persistently, it can lead to avoidance of and anxiety about sexual interactions. In terms of criteria 4, the tensing and tightening during attempted vaginal penetration can be involuntary spasms or “normal/voluntary” guarding due to anticipated or repeated pain or the anxiety and fear regarding pain.

Even when sexual desire and interest is preserved, many find that they still avoid sexual opportunities, and as a result may experience relational issues.

How can GPPPD be treated?

The etiology of GPPPD is not well known and it remains under-researched...

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