women s health issues
Genito Pelvic Pain Penetration Disorder
Diagnosis of Genito Pelvic Pain Penetration Disorder
Doctor's evaluation, based on specific criteria Doctors diagnose genito-pelvic pain/penetration disorder based on the woman’s description of the problem, including when and where the pain is felt, and on the results of a pelvic examination. The pelvic examination can detect or rule out physical abnormalities. If a woman has a history vaginal pain, the anticipation of pain and involuntary contraction of muscles around the vagina's opening can make it difficult to have a pelvic examination. This can be discussed with the doctor before the examination. Some strategies for making a pelvic examination more tolerable are as follows: A woman and her doctor can discuss the examination before it begins and agree on how to communicate during the examination. A woman can hold a mirror to be able to see what the doctor sees during the examination and allow the doctor to show her any issues that are detected. A woman can place her hand on the doctor’s hand to have a greater sense of control during the examination. The area in and around the opening of vagina is examined for possible causes, such as signs of inflammation or abnormalities. To determine where the pain occurs, a doctor may use a cotton swab to touch different areas around and/or in the vagina. Doctors may also press on the urethra and bladder to check for tenderness. The doctor assesses the tightness of the pelvic muscles around the vagina by inserting one or two gloved fingers into the vagina. To check the uterus and ovaries for abnormalities, the doctor then places the other hand on the lower abdomen (called a bimanual examination) and presses on these organs. A rectal examination may also be done. Doctors diagnose genito-pelvic pain/penetration disorder based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association. These criteria require the presence of at least one of the following: Significant pain during intercourse or penetration attempts Significant fear or anxiety about pain in anticipation of, during, or because of vaginal penetration Significant tensing or tightening of the pelvic muscles during attempts to penetrate the vagina These symptoms must have been present for at least 6 months and must cause significant distress in the woman. Also, doctors must rule out any other cause of the symptoms, such as another disorder, sexual trauma, or medication or other substance. 