Hello dear listener! This is episode five of The Sensate Space podcast, a psychology show about vaginismus / GPPPD and other pelvic and sexual pain disorders, this time talking about our recommendations for building your pelvic pain treatment team.
You can listen in here or using the player below.
SUMMARY
Feeling stuck with your progress? Wondering what your option for pelvic pain treatment support might be?
In this episode we discuss:
- The importance of a team approach in treating pelvic pain conditions.
- Three main points to consider when building your treatment team: trial and error, changing treatment needs over time, and co-occurring conditions.
- Which professionals to consider including in your treatment team and why
- Barriers to accessing a treatment team.
TRANSCRIPT
Welcome back! In this episode, we'll explore why a team approach to treatment is so important. I’ll walk you through some of the various professionals who can assist you and practical steps to access the care you require.
Having a solid support team can make a world of difference in treating pelvic pain conditions like genti-pelvic pain/penetration disorder (or GPPPD) because each professional has a different skill set. Generally speaking, these conditions are multifaceted and each person is likely to be a bit different in what they need for support. That is, treatment works best when it’s targeted to the individual rather than a one size fits all. A good treatment approach should address biopsychosocial factors: your biology and physical body, the mind, and your broader context.
Main Points To Consider When Building Your Pelvic Pain Treatment Team
There are three main points to consider when you’re thinking about building your treatment team.
- First of all, there might be a bit of trial and error to work out who you need and in what capacity. Sometimes it might just be a once off assessment - to work out a treatment plan or rule out other issues - but other times you might need ongoing support and coaching to do the work.
- Secondly, be aware that your treatment needs might vary over time, depending on what is happening in your life at the time. Having general health issues? Relationship changes? Feeling stressed or run down? This can all change how your body is functioning, including altering your pain experience.
- Finally, there are many conditions that co-occur with pelvic pain - physically and psychologically - so different professionals can play a role in screening for or helping you manage these conditions too, as this can also impact your pain experience.
So, with those three points in mind, let’s walk through some of the different services that can form part of a treatment team. Now, I’m speaking from Australia so if you’re overseas it might mean that some of the referral pathways or titles are a bit different.
Services That Can Form Part of a Pelvic Pain Treatment Team
- General practitioner or GP: Your usual doctor is a perfect starting point. They can give an initial opinion, manage referrals, screen for co-morbid issues, and keep eyes on your treatment overall. They’re generally a first port of call, so to say.
- Next we have a gynaecologist. Gynaecologists can undertake a thorough assessment of your concerns, and explore treatment options like medication and surgery as required. They usually require a referral from your treating doctor.
- Women’s health physiotherapist (physical therapist if US based) is another important member of the treatment team for many people with this condition. It’s important to see a physio who specialises in pelvic floor work and pain management. They can assess to see if your pelvic floor is functioning as it should and, if not, what you can do about it. Physio’s can also have a wealth of knowledge around pain management, and can help with some of the mental blocks to treatment too. You can usually self-refer, but it is useful to have them linked in with your treatment team.
- In some cases, a dermatologist specialising in women’s health conditions can be helpful to rule out or treat any skin issues. You can talk to your GP about whether or not this may be useful in your case.
- Next, a sexologist or sex therapist can help to identify any psychological and/or sexual barriers, and help you to move past them. They can also help with relationship issues relating to intimacy, including couples work (depending on the therapist). Sexologists can also be a great source of education - I’ve been speaking with friends over the years about just how little we learned in school sex ed - about our bodies, consent, communication, etc, and a sexologist can help fill in the gaps.
- Finally, you can consider a psychologist on your team. GPPPD is multifaceted and working with the body and the mind has the best outcomes for treatment. Depending on what you need, find someone that is experienced in pain management and sexuality. They can help you to identify and work through any psychological barriers to treatment. We also know that GPPPD co-occurs at a higher rate with anxiety and depression than the general population, which can further interact with pain experiences, so it’s important to make sure that your mental health is cared for too.
This is just a starting point - obviously you don’t need to see everyone at once, but a thorough assessment from a gynaecologist and women’s health physiotherapist is a really solid starting point. If you feel stuck, consider seeing what some of the other services have to offer. What other services can you think of? What has helped you?
Now, I do understand that it is a privileged position to be able to access a full treatment team, unfortunately. These services are inaccessible to a lot of people due to cost, distance (if you’re in the country), and long waitlists. If ongoing treatment isn’t an option, you can ask about getting an assessment and a treatment plan to work on at home. You can also talk to your GP about what options might be available in your area - whether there are any services that bulk bill, such as university clinics. While you’re waiting for appointments you can also seek resources by the professionals who have expertise in this space - for example books, podcasts, or trainings.
Unfortunately, we know that it can take a while to get the right type of help. A study by O’Hara, Rowe and Fisher in 2022 surveyed 620 women and found that it took - on average - almost 6.5 years to go from reporting pain symptoms to a diagnosis. This was referring mainly to endometriosis, so I do wonder if it would be even longer for the less-well-recognised conditions like GPPPD. Because of this - it’s important that you keep persisting to get answers: request follow-up appointments, ask about referrals. GPPPD is a treatable condition, there are so many pathways and options for treatments, if you haven’t had luck so far keep trying.
Summary
So, to recap - pelvic pain conditions, such as GPPPD are unique to each individual and require a biopsychosocial approach.. That's why assembling the right team of professionals is so important. We want to see a treatment team tailored to your individual needs, which are likely to change as you, and your situation, change over time.
Some key team members can include your trusted general practitioner, gynaecologists and women’s health physiotherapists, dermatologists, sexologists, and psychologists. You don't have to see everyone at once; it's about building a team that works for you at the time.
It can be really hard to access the right services at the right time. Persistence is key. GPPPD is treatable so keep seeking the help you need - you deserve nothing less. You’ve got this!
If you liked this episode, don’t forget to check out our free resources at thesensatespace.com.
References
O’Hara, R., Rowe, H., & Fisher, J. (2022). Managing endometriosis: a cross-sectional survey of women in Australia. Journal of Psychosomatic Obstetrics & Gynecology, 43(3), 265-272.
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This is a psychology podcast about vaginismus and other pelvic and sexual pain disorders, and related issues (genito-pelvic pain/penetration disorder, dyspareunia, vulvodynia, painful intercourse, gynaecological pain, sexual dysfunction, chronic pelvic pain) for the purpose of education and collaboration; it’s not therapy or medical advice. Information is general in nature and does not replace individualised assessment or treatment advice. Please seek professional support tailored to your specific needs. If you or someone you know is in crisis and needs help now, call triple zero (000). You can also call Lifeline on 13 11 14 — 24 hours a day, 7 days a week. Please see our About page for more information.