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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 M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by Alexandra B.

Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

-- Alexandra B., 5/20/2015 via Yelp!

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

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

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