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Painful Sex & GPPD | Image Courtesy of Taras Chernus via Unsplash
Painful Sex & GPPD | Image Courtesy of Taras Chernus via Unsplash

The medical community has a new acronym for painful sex - GPPD

New data on self-compassion and emotion regulation that many women who suffer from it may never have considered.

First, let’s take a look at that new name - genito-pelvic pain/penetration disorder (GPPD). That’s a medical mouthful, I know; but it’s actually a helpful attempt to simplify diagnosis by combining two similar disorders under one treatment heading. Dyspareunia is pain with sexual activity; vaginismus is the involuntary contraction of muscles in the pelvic floor that often cause that pain. GPPD recognizes them as essentially the same problem – recurrent or persistent pain in the genital area associated with intercourse. And it’s a common one; the study I’m reviewing in this article says,

Sexual pain is among the most common complaints in women who seek for help in clinical settings.”

And the American College of Obstetricians and Gynecologists Agree – citing that 3 out of 4 women will experience painful intercourse at some point in their lives.

\When I first began studying women’s health physical therapy, it was a real struggle to get the medical community to embrace the idea that the pain was real. These days, we know that an entire laundry list of physical factors – infection, injury, birth trauma, hormonal changes – can cause or contribute to the physical pain. The new frontier of GPPD research offers us important details about the psychosocial risk factors – a wide range of issues from various types of abuse and trauma to extreme religiosity to anxiety, depression, and even the way our brains are wired to view negative experiences.

The earlier focus on data about the physical aspects and causes of GPPD was invaluable in helping us understand how to treat it.

Can the new focus on the psychological aspects – and on common psychological wellness techniques – do the same for GPPD?

That’s what a research team in Portugal wanted to know; so they studied more than 200 women to find out if there was a link between sexual pain, self-compassion, and emotion regulation. Their survey questioned three types of sexually active adult women – those who reported sexual pain, those who indicated some other kind of sexual dysfunction, and sexually healthy women who said sex was pain-free. The researchers asked all of them questions about their sex lives as well as about how they viewed and treated themselves.

It probably won’t surprise you (and didn’t surprise the team) to find that women in the first two groups lacked self-compassion and had a hard time regulating emotions. But their more specific findings are worth a read – for all women, but especially those suffering from painful sex.

Self-Compassion is never the problem. 

If I had a dollar for every tearful patient or social media follower who told me they’d gotten well-meaning advice (even from doctors) to ‘power through the pain’, ‘be an adult’, or ‘just get over it’, I could retire and offer all my services for free. I’m thrilled that this hard data puts those toxic recommendations to rest. The survey shows women who suffer from sexual pain aren’t avoiding the problem, at least not internally. They offered far less kindness and understanding to themselves than they did to others who were suffering or had some perceived inadequacy. What’s more, they tended overwhelmingly to view their GPPD related pain as a personal failure rather than a condition that all humans face at some point through no fault of their own. Clearly, those of us in the medical community have some work to do in supporting patients; but this is hopeful news for every woman who has ever been led to believe that they could overcome sexual pain just by being harder on themselves. 

Emotion regulation may not be what you assume it is, either. 

The women who struggled with painful sex in this study had a higher difficulty sticking to goals and controlling impulsive behavior during negative experiences… but to some extent, that’s human nature. In particular, these women also had a hard time simply accepting their own emotional responses. In other words, the more they told themselves (or listened to someone else tell them) how and what they should feel about their sexuality, their pain, and even the healing process, the worse they felt when authentic emotions surfaced… and the less able they were to use coping strategies that had been helpful to them in the past.

Seeking Treatment for GPPD

GPPD (dyspareunia, vaginismus) is one of the sexual dysfunctions we specialize in at Femina PT. Our expertise goes beyond some of the most highly trained women’s health physical therapists in the country; your entire experience with every team member offers the compassionate and professional support you need to heal, from the very first phone call. Painful sex is a physical, treatable condition – but how you’re treated, and how you treat yourself, can optimize your healing.

 

References:

Vasconcelos P., Oliviera C., and Nobre P. 2019. Self-Compassion, Emotion Regulation, and Female Sexual Pain: A Comparative Exploratory Analysis. The Journal Of Sexual Medicine 17:2  289-99.

When Sex Is Painful - Frequently Asked Questions at ACOG

What Our Patients Have to Say

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Testimonial by Carolina J.

I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

-- Carolina J., 12/28/16 via Yelp!

Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Y.L. (mom of 2)

After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

Y.L. (mom of 2)

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

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