Hi there! Thanks for tuning in. This is episode six of The Sensate Space podcast, a psychology show about vaginismus / GPPPD and other pelvic and sexual pain disorders. In this episode we unpack the essential pelvic pain jargon and vocab so that you can make the most of your healthcare experiences.
You can listen in here or using the player below.
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SUMMARY
Feeling a bit overwhelmed with all the pelvic pain jargon and words that are used in your medical or allied health appointment?
In this episode, we discuss:
- Common terms used in pelvic and sexual pain treatment (demystifying medical jargon!)
- Definitions and explanations of terms like dyspareunia, vaginismus, GPPPD, vestibulodynia, vulvodynia, atrophy, dystrophy, neuralgia, neuropathic pain, and nociceptive pain.
CHEAT SHEET
- Dyspareunia: Painful intercourse, which can be introital (at the entrance) or deep in the pelvis.
- Vaginismus: A condition where muscle contraction creates a barrier to intercourse, Pap smears, or tampon use.
- Genito-pelvic pain/penetration disorder (GPPPD): An umbrella term encompassing dyspareunia and vaginismus.
- Vestibulodynia: Pain or discomfort in the vestibular area.
- Vulvodynia: Chronic pain or discomfort, often described as burning or stinging, in the vulvar region.
- Atrophy: The wasting away or reduction of body parts or tissue, often due to hormonal changes.
- Dystrophy: Abnormal growth or development of body parts or tissue.
- Neuralgia: Sharp, severe, and recurring pain along the course of a specific nerve or nerve pathway.
- Neuropathic pain: Pain caused by damage or dysfunction of the nervous system, often described as shooting or burning.
- Nociceptive pain: Pain caused by the activation of pain receptors (nociceptors) in response to tissue damage or injury.
TRANSCRIPT
This episode was designed to help you get familiar with common terms so that you can better understand some of the language used by professionals, written in your referrals, and access the research more easily.
A good professional should always talk in plain, everyday language - but unfortunately that isn’t always the case, especially if they might be busy or rushed.
It’s not up to the patient to have to do the work - but sometimes it can help in the moment.
You can - and should - always ask for clarity. It's your right to understand what is happening in your care, and it’s the role of the professional their role to explain to you in a way that makes sense - in plain English, particularly if you’re consenting for a service (on that note - we have an earlier episode on medical consent, available at thesensatespace.com/pod2 that’s p-o-d-numeral2 if you’re interested)
So. This episode I’ll introduce some common terms that may or may not be relevant to you as you seek help in this space. These are terms that professionals might use when they talk to you, or you might see included in your medical history/notes or referrals. It’s not an exhaustive list, just a start, but I’d love to hear from you if you can think of some more terms I should cover - reach out on Insta or via the website contact page. I’ve included the definitions in the show notes, so there’s no need to try to memorise it all while I’m speaking!
We’ll start with a really common one - dyspareunia. Dys meaning difficult or impaired, and pareunia meaning sex. So dyspareunia is a term used in medical circles to refer to painful intercourse. You might also hear the term ‘coital pain’. Within this, a patient can have introital dyspareunia, or pain at the entrance or opening, or it can be deep dyspareunia which refers to pain deep in the pelvis or lower abdomen.
You might also hear the term “vaginismus”. This refers to a condition where muscle contraction where the muscles act as a physical barrier to intercourse, Pap smears or using tampons, etc.
Genito-pelvic pain/penetration disorder or GPPPD is a fairly new diagnosis, only used in the last ten years with the release of DSM-5, a diagnostic manual. It’s classed as female sexual dysfunction, and encompasses two earlier conditions known as dyspareunia and vaginismus. So, in recent years the research will refer to this condition, but older studies will use the earlier terms. Your professional might use either term, or both. GPPPD is an umbrella term, A broad title m encompassing various sexual pain disorders.
Next, is the suffix or word ending “dynia”. Dynia just means “pain” or “discomfort”. Some ways that you might hear this in the pelvic pain space is when professionals refer to vestibulodynia - so vestibular pain or discomfort, or vulvodynia - which is a term used to describe chronic pain or discomfort (usually a burning or stinging) in the vulvar region.
Okay, two more terms that you might hear of are atrophy and dystrophy. Atrophy is when body part or tissue wastes away or reduces, for example due to hormonal changes. Dystrophy is the opposite - that’s when we see abnormal growth.
Next we have two related - but slightly different terms - neuralgia and neuropathic pain. Neuropathic pain is a broad term that refers to pain caused by damage or dysfunction of the nervous system. It’s often described as a shooting or burning sensation. Neuralgia is a more specific term referring to sharp, severe, and often recurring pain along the course of a nerve.
It can be a type of neuropathic pain but is generally used to describe pain that is localized to a specific nerve or nerve pathway. So, while neuropathic pain is a broader category encompassing pain resulting from nervous system damage, neuralgia specifically refers to sharp, severe pain along specific nerves or nerve pathways. Neuralgia can be a type of neuropathic pain, but not all neuropathic pain is neuralgia.
Finally, we have nociceptive pain. This is pain caused by the activation of nociceptors (pain receptors) in response to tissue damage or injury - like if you roll your ankle or touch a hot plate.
So, to recap - the terms neuropathic and nociceptive both refer to types of pain. The key difference between neuropathic and nociceptive pain lies in their underlying causes. Neuropathic pain is rooted in problems with the nervous system, while nociceptive pain arises from the activation of pain receptors due to tissue damage or injury (like a broken arm).
Generally speaking, the consensus in the research is that many genito pelvic pain experiences like vulvodynia have both neuropathic and nociceptive elements, although newer perspectives are challenging this. You can check out the reference list in the show notes if you’re interested!
Summary
So, to recap - it’s your right as a healthcare consumer to understand what's happening in your care. That is, it’s the role of your healthcare professional to explain things to you in plain English, without jargon. You can, and should, always ask for clarity when you need it. But, I hope some of these terms and explanations might make the process seem a little less daunting. As they say, knowledge is power.
References
Armstrong SA, Herr MJ. Physiology, Nociception. 2023 May 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31855389.
Conforti, C. (2017). Genito-Pelvic Pain/Penetration Disorder (GPPPD): An overview of current terminology, etiology, and treatment. University of Ottawa Journal of Medicine, 7 (2), 48-53.
Graziottin, A., Gambini, D. (2017). Evaluation of Genito-Pelvic Pain/Penetration Disorder. In: IsHak, W. (eds) The Textbook of Clinical Sexual Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-52539-6_20
Nicholson B. Differential diagnosis: nociceptive and neuropathic pain. Am J Manag Care. 2006 Jun;12(9 Suppl):S256-62. PMID: 16774457.
Purves D, Augustine GJ, Fitzpatrick D, et al., editors. Neuroscience. 2nd edition. Sunderland (MA): Sinauer Associates; 2001. Hyperalgesia and Sensitization. Available from: https://www.ncbi.nlm.nih.gov/books/NBK10999/
Schlaeger, Judith M.a,*; Patil, Crystal L.a; Steffen, Alana D.b; Pauls, Heather A.c; Roach, Keesha L.d; Thornton, Patrick D.a; Hartmann, Deee; Kobak, William H.f; Yao, Yingweig; Suarez, Marie L.d; Hughes, Tonda L.h; Wilkie, Diana J.g. Sensory pain characteristics of vulvodynia and their association with nociceptive and neuropathic pain: an online survey pilot study. PAIN Reports 4(2):p e713, March/April 2019. | DOI: 10.1097/PR9.0000000000000713
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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.