Pain during sex and pain whilst inserting a tampon is a common and frustrating issue many women have. You may not realise, but a women’s health physiotherapist is qualified to be able to help you overcome this sensitive issue.

Do you have any of the following issues?

  1. Pain with Sex
  2. Finding sex impossible or difficult due to a blocking feel
  3. Painful or impossible to have a Pap Smear
  4. Feel like there is not enough space in your vagina to have sex or insert a tampon
  5. Pain or its impossible to insert a tampon

If you have all or any of these issues you may have something called Genito-pelvic pain/penetration disorder (This disorder used to be called Vaginismus or Dyspareunia).

What is Genito-pelvic pain/penetration disorder (GPPPD)?
Genito-pelvic pain/penetration disorder is a condition where the pelvic floor muscles surrounding the vagina tighten or contract whenever there is an attempt by something to penetrate the vagina. This could be tampon insertion, sexual intercourse, a speculum being inserted for a pap smear, etc. The automatic response of tightening the pelvic floor muscles can cause pain and/or a blocking feeling.

To be diagnosed with GPPPD you must have at least one of the following persistent or recurrent issues for at least 6 months

  1. Difficulties with vaginal penetration during intercourse
  2. Vaginal or pelvic pain during vaginal intercourse or penetration attempts
  3. Fear or anxiety associated with vaginal pain, pelvic pain or vaginal penetration
  4. Tightness of the pelvic floor muscles during attempted vaginal penetration

Do many people have Genito-pelvic pain/penetration disorder (GPPPD)?
Due to the change in name of this condition over the years and the varying assessment methods, it is hard to know the percentage of people who suffer from this condition but within the general population, it is somewhere between 10-20%.

What causes Genito-pelvic pain/penetration disorder (GPPPD)?
The actual cause of GPPPD is unknown but researchers have found some factors which seem to be associated with it:

  • Fear of pain
  • Lack of sexual education and other sociocultural factors
  • Virginity myths
  • Vaginal infections or other gynaecological conditions (e.g endometriosis)
  • Vaginal atrophy or dryness after menopause
  • Past sexual abuse
  • Poor body image
  • Relationship conflict
  • Poor communication with partner
  • Trauma to the perineum during childbirth
pain with sex and tampon

What is the treatment for Genito-pelvic pain/penetration disorder (GPPPD)?
First, go to your doctor to rule out any other issues which may be causing pain around the vagina. The doctor may send you to a gynaecologist to rule out other conditions as well. Once everything else has been cleared, you can come and see a Women’s Health Physiotherapist.

How can a Women’s Health Physiotherapist help with Genito-pelvic pain/penetration disorder (GPPPD)?

Our number one aim is to help you reach your goals, which for many women with GPPPD, is to reduce pain, to improve sexual intercourse, to be able to insert a tampon or to have a pain-free internal examination with a doctor. During a Women’s Health Physiotherapy session there is no such thing as a silly question, so bring all your questions regardless of how embarrassing you think they are.

A Women’s Health Physiotherapist does this by having a very holistic approach and looking at all aspects of your life. This may include:

  • Assessing your pelvic floor activity – are they overactive and contributing to pain?
  • Looking at your bladder and bowel habits
  • Treating any symptoms of painful intercourse
  • Systematic desensitisation (Assessing your body’s protective response to pain and changing the input into your system to relieve pain).
  • Mindfulness
  • Teaching the pelvic floor to relax and slowly stretch using vaginal dilators
  • Introducing exercise (including clinical movement therapy) and stretches which will help your body relax
  • Trigger point release or acupuncture to reduce muscle tension around painful areas
  • Manual therapy and myofascial pelvic and abdominal massage to release scar tissue, adhesions, spasms, fascial and muscle tightness.
  • Working in conjunction with the specialist who is managing your GPPPD

Amy Tinetti is a Masters Qualified Women’s Health Physiotherapist. To make an appointment with Amy, call (08) 6389 2947 or click here to book online