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Other Sexual Disorders: Genito-Pelvic Pain/Penetration Disorder

Lorraine Benuto, Ph.D., edited by C. E. Zupanick, Psy.D.

woman in pain on couch Previously there were 2 conditions known as Sexual Pain Disorders - Dyspareunia and Vaginismus. In the DSM-5, these have been merged into a single condition called Genito-Pelvic Pain/Penetration Disorder. For a woman to be diagnosed with this condition, there must be persistent or ongoing difficulties with one or more of the following for at least 6 months:

  • vaginal penetration during intercourse
  • marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts
  • marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during or as a result of vaginal penetration
  • marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration

The symptoms must cause significant stress in the female's life.

They must also not be the result of a mental disorder, severe relationship distress (such as partner violence), a medical condition, or because of a substance or medication.

The clinician should specify whether the condition is:

  • Lifelong - the problems have been present since the person became sexually active
  • Acquired - the problems began after a period of relatively normal sexual function

Finally, the condition can be mild, moderate or severe depending on the level of stress over the symptoms that are happening.

It is unclear how many women suffer from this condition. However, about 15% of women in North America report recurrent pain during intercourse.

Treatment Options

In terms of treatment, women may wish to see a pelvic floor therapist. The pelvic floor is a group of muscles, tissue, and ligaments that connect from the pubis bone in front to the tailbone in back. They act as a sling and support the internal organs and promote bowel and bladder continence. The pelvic floor plays a very important role in sexual function, especially when pain is involved. People suffering from sexual pain may need to undergo a thorough evaluation of the pelvic floor and may be encouraged to engage in pelvic floor exercises. Pelvic floor therapists can also provide education regarding the physical and anatomical characteristics of the genitals. Additionally, they may instruct women to use vaginal dilators, engage in pelvic floor muscle strengthening exercises, and relaxation exercises. Females experiencing pain may be instructed to avoid irritants such as synthetic garments, detergents, and feminine products (Rosenbaum, 2007).

It is important to keep in mind that relationship factors may play a role in the development, maintenance, and/or worsening of this condition. Therefore, it is important that relationship factors be addressed. While many women report that their partners are understanding and supportive, they also report feeling as though their partners may become impatient or unhappy because of the decreased frequency of intercourse and the chronic complaints about the sexual pain (Davis & Reissing, 2006).