Encyclopedia of Couple and Family Therapy

2019 Edition
| Editors: Jay L. Lebow, Anthony L. Chambers, Douglas C. Breunlin

Genito-pelvic Pain/Penetration Disorder in Couple and Family Therapy

  • Adam R. FisherEmail author
  • Laura Holt
  • Kristin M. Bennion
Reference work entry
DOI: https://doi.org/10.1007/978-3-319-49425-8_460


The probable first known reference to symptoms of what would later be called genito-pelvic pain/penetration disorder (GPPPD) came in the 1547 treatise on “The Diseases of Women” that referred to “a tightening of the vulva” (Of Salerno 1547/1940). This tightening, along with uncontrollable spasms of the vulvovaginal canal (“vaginismus”; Jeng 2004), and painful vaginal intercourse (“dyspareunia”) would eventually be categorized together under one diagnosis. GPPPD consists of difficulties with vaginal penetration, pain during attempts at or actual vaginal intercourse, anxiety about this pain, or tightening or tensing of pelvic floor muscles during attempted vaginal penetration (American Psychiatric Association 2013).

Theoretical Context

The etiology of the symptoms of GPPPD was disputed among medical professionals, who initially attributed the spasms to a variety of causes. Hypotheses included an inability to reach sexual maturity, resistance to marriage related to...

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  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.CrossRefGoogle Scholar
  3. Davis, S., Bergeron, S., Binik, Y. M., & Lambert, B. (2013). Women with provoked vestibulodynia experience clinically significant reductions in pain regardless of treatment: Results from a 2-year follow up study. Journal of Sexual Medicine, 10, 3080–3087.  https://doi.org/10.1111/jsm.12309.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Jeng, C. (2004). The pathophysiology and etiology of vaginismus. Taiwanese Journal of Obstetrics and Gynecology, 43(1), 10–15.  https://doi.org/10.1016/S1028-4559(09)60047-4.CrossRefGoogle Scholar
  5. Meana, M., Maykut, C., & Fertel, E. (2015). Painful intercourse: Genito-pelvic pain/penetration disorder. In K. M. Hertlein, G. R. Weeks, & N. Gambescia (Eds.), Systemic sex therapy (2nd ed., pp. 191–215). New York: Routledge.Google Scholar
  6. Meana, M., Fertel, E., & Maykut, C. (2017). Treating genital pain associated with sexual intercourse. In The Wiley-Blackwell Handbook of Sex Therapy (pp. 98–114). Malden: John Wiley & Sons Ltd.CrossRefGoogle Scholar
  7. Of Salerno, T. (1940). The diseases of women (trans: Mason-Hohl, E.). Los Angeles: The Ward Ritchie Press. (Original work published 1547).Google Scholar
  8. Reissing, E. D., Binik, Y. M., & Khalifé, S. (1999). Does vaginismus exist? A critical review of the literature. Journal of Nervous and Mental Disease, 187, 261–274.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Adam R. Fisher
    • 1
    • 2
    Email author
  • Laura Holt
    • 3
  • Kristin M. Bennion
    • 4
    • 5
  1. 1.The Family Institute at Northwestern UniversityEvanstonUSA
  2. 2.Brigham Young UniversityProvoUSA
  3. 3.University of Missouri-St. LouisSt. LouisUSA
  4. 4.California Institute of Integral StudiesSan FranciscoUSA
  5. 5.Intimate Connections CounselingOremUSA

Section editors and affiliations

  • Farrah Hughes
    • 1
  • Allen Sabey
    • 2
  1. 1.Employee Assistance ProgramMcLeod HealthFlorenceUSA
  2. 2.The Family Institute at Northwestern UniversityEvanstonUSA