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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

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Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

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Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

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Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

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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!

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