Limits of Pelvic Floor Physical Therapy in the Treatment of GPPD
Genito-pelvic pain/penetration disorder (GPPD) first appeared in the most recent edition of the DSM . It is a consolidation of presentations listed in the previous DSM  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 .
The generality and inclusiveness of GPPD represent the lack of a clear and concise understanding of the specific etiology and treatment needs of women who present for treatment. The...
Compliance with Ethical Standards
Conflict of Interest
The author declares that he/she has no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
- 2.American Psychiatric Association. Diagnostic and statistical manual of mental disorders 4th edition, text revision. Arlington: American Psychiatric Publishing; 2000.Google Scholar
- 3.Tosh J, Carson K. A Desire to be ‘normal’? A discursive and intersectional analysis of ‘penetration disorder’. Intersectionalities Glob J Soc Work Anal Res Polity Pract. 2016;5(3):151–72. RetrievedGoogle Scholar
- 8.Rosenbaum, TY Physical therapy treatment of sexual pain disorders in text Principles and Practice of Sex Therapy Edited by Sandra Leiblum, PhD Guilford Publications; 2007.Google Scholar
- 12.Rosenbaum, TY An integrated mindfulness-based approach to the treatment of women with sexual pain and anxiety: promoting autonomy and mind/body connection. J Sex Rel Ther. https://doi.org/10.1080/14681994.2013.764981.
- 14.Van der Velde J, Laan E, Everaerd W. Vaginismus, a component of a general defensive reaction: an investigation of pelvic floor muscle activity during exposure to emotion-inducing film excerPhysical therapists in women with and without vaginismus. Int Urogynecol J. 2001;12:328–31.CrossRefGoogle Scholar
- 18.Laan E, van Lunsen RHW. Overactive pelvic floor: female sexual functioning. In: Padoa A, Rosenbaum T, editors. The Overactive Pelvic Floor. Cham: Springer; 2016.Google Scholar
- 24.Kleinplatz. History of the treatment of female sexual dysfunction(s) Annual Review of Clinical Psychology. 2018Google Scholar