Limits of Pelvic Floor Physical Therapy in the Treatment of GPPD

Excerpt

Genito-pelvic pain/penetration disorder (GPPD) first appeared in the most recent edition of the DSM [1]. It is a consolidation of presentations listed in the previous DSM [2] under the category of “sexual pain disorders” (SPDs). The former binary division between vaginismus, an involuntary spasm of the musculature of the outer third of the vagina, that interferes with sexual intercourse, and dyspareunia, the actual experience of pain with penetration, likely contributed to the incorrect conceptualization of dyspareunia as organic and vaginismus as psychological at the core. The new designation acknowledges a multifactorial experience for both pain and defensive reactivity, as they co-exist, but continues to focus on the ability to be penetrated as a fundamental determinant of sexual function in women [3]. …