PODCAST #2. What is GPPPD? Sexual Pain Symptoms Explained (Vaginismus, Dyspareunia)

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Hello dear listener! This is episode two of The Sensate Space podcast, a psychology show about vaginismus and other pelvic and sexual pain disorders, answering the question - what is GPPPD, anyway? This episode is explores the symptoms of Genito-Pelvic Pain/Penetration Disorder (GPPPD), a female sexual pain condition encompassing dyspareunia and vaginismus.  You can listen in here or using the player below. Display content from Spotify Click here to display content from Spotify. Learn more in Spotify’s privacy policy. Always display content from Spotify In this episode, we're discussing Genito-Pelvic Pain/Penetration Disorder (GPPPD), a female sexual dysfunction condition. GPPPD combines dyspareunia and vaginismus, affecting around 14-34% of pre-menopausal women. We'll discuss various symptoms, including pain during intercourse, fear of pain, and the emotional impacts. This condition varies from person to person. For more on managing GPPPD and access to resources, including a free eBook guide, visit our website at www.thesensatespace.com. KEY MESSAGES: In this episode, we're here to have an open conversation about the symptoms and experiences of Genito-Pelvic Pain/Penetration Disorder, commonly known as GPPPD. 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. The prevalence is around 14-34% of pre-menopausal women. Some of the symptoms discussed in this episode: Pain with tampons Fear of pain Pain with intercourse Painful Pap Smears and other physical examinations Feeling of a barrier  Emotional impact Like many conditions, GPPPD can present differently person to person, and there are more signs and co-occurring symptoms that aren’t listed here. For information and resources about managing GPPPD, including our free eBook guide to managing physical examinations and pap smears, visit our website at www.thesensatespace.com. TRANSCRIPT: In this episode, we're here to have an open conversation about the symptoms and experiences of Genito-Pelvic Pain/Penetration Disorder, commonly known as GPPPD (which is such a clunky acronym to say aloud!). We’ll follow how these signs show up in day-to-day life, through the story of Sally - a fictional woman based on the typical experience of someone with this condition.  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. The prevalence is around 14-34% of pre-menopausal women, but this is probably a considerable underestimate due to the sensitive nature of the condition, and - like many other women’s health conditions - possibly a lack of recognition amongst medical professionals.  Let’s walk through some of the symptoms together in this episode.  GPPPD Symptom 1. Pain with Tampons: For Sally, using tampons has always been a painful experience, and some days it is physically impossible. This has led to anxiety and avoidance of tampon use altogether. GPPPD Symptom 2. Fear of Pain: Sally's fear of pain overwhelms her with anxiety, tension, and anticipatory distress before engaging in sexual activities or undergoing gynaecological examinations.  She is beginning to avoid intimate relationships.  GPPPD Symptom 3. Pain with Intercourse: Dyspareunia, or pain during sexual intercourse, adds to Sally's distress. The pain she feels ranges from a dull ache to sharp and intense stabs. This can change with fluctuations in her hormones, stress levels, etc.  GPPPD Symptom 4. Painful Pap Smears: Sally finds routine gynaecological examinations, like Pap smears, painful. The physical pressure applied during a pelvic exam triggers pelvic pain and distress. (PS- if this is sounding familiar to any of you, make sure you visit thesensatespace.com and grab your copy of the free guide to managing physical examinations).  GPPPD Symptom 5. Feeling of a Barrier: Sometimes Sally experiences the sensation of a physical barrier, or wall of muscle, blocking the way when trying to use a tampon or attempting intercourse.  GPPPD Symptom 6. Emotional Impact: Beyond the physical symptoms, GPPPD takes a toll on Sally's emotional well-being. Coping with chronic pain and fear of pain, and avoiding what can cause pain leads to increased levels of anxiety. Sally feels shame, like she is broken, and it’s isolating. It’s starting to impact her overall quality of life. Like many conditions, GPPPD can present differently person to person, and there are more signs and co-occurring symptoms that aren’t listed here. This is why an independent assessment by a gynaecological specialist and women’s health physiotherapist is so important for developing your own unique treatment plan - it’s never one size fits all.  Summary: To recap - GPPPD is characterised by recurrent and persistent pain associated with intercourse or similar activities, increased tension or anticipation of pain before these activities, and involuntary contraction of pelvic floor muscles (aka the barrier). Remember, there are so many treatment options available for this condition. Exactly what will be helpful for one person depends on how their symptoms are presenting, along with their own physical makeup, experiences, and beliefs - so make sure you seek out a thorough assessment and build a treatment team that can address exactly what you need. You’ve got this - but there’s no need to go alone! If Sally's experiences resonate with you or someone you know, know that help is available. For  information and resources about managing GPPPD, including our free eBook guide to managing physical examinations and pap smears, visit our website at www.thesensatespace.com .  Now, this episode has discussed topics that can feel really big or overwhelming at times. If you need extra support please contact your medical and allied health team, or phone lifeline on 13 11 14 for MH support References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 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. Dias-Amaral, A., & Marques-Pinto, A. (2018). Female genito-pelvic pain/penetration disorder: review of the related factors and overall approach. _Revista Brasileira de Ginecologia e Obstetrícia_, _40_, 787-793. Graziottin,

PODCAST. Sneak Peek: Psychology & Pelvic Pain

Image for The Sensate Space podcast about pelvic and sexual pain disorders like vaginismus / GPPPD. The words 'The Sensate Space PODCAST' are written over a photograph of a microphone on the desk. There is a taupe banner at the bottom with the website details.

Hello dear listener! Welcome to the first episode by The Sensate Space: a psychology podcast about vaginismus and other pelvic and sexual pain disorders. You can listen in here or using the player below. Display content from Spotify Click here to display content from Spotify. Learn more in Spotify’s privacy policy. Always display content from Spotify Transcript Hi, welcome to the very first sneak peek into The Sensate Space podcast! It’s wonderful to have you here. This episode is a short trailer to outline what you can expect when you tune in to this show.  The Sensate Space is your podcast dedicated to understanding and managing pelvic pain, with a special focus on chronic intimate pain and sexual pain disorders. If this is relevant for you, know that you’re not alone - prevalence studies are showing this is the case for about a third of  women, to some extent, and there’s a good chance that it is often underreported.  You can expect weekly, bite-sized chunks of general education about these pain experiences, with a focus on the role of psychology.  The Sensate Space is mainly a solo show, but we’ll host some guests from time to time. Do you have someone in mind? Let me know!  This show is absolutely not designed to replace medical and allied healthcare. So, just think of it as an extra bit of support in your earbuds. I’d love to hear what you’re interested in learning from the show - do you have a topic or question in mind? Hit me up on my socials, or via the contact page on our website. All the links are in the show notes. Last of all - I’d like to invite you to keep an eye on thesensatespace.com as we’ll be constantly adding resources and freebies to complement episodes. So, thank you for joining me here today. I hope you’ll stay tuned and check out some of our new episodes as they’re released.  You’ve got this! References Katharina A. Azim, PhD and others, Exploring Relationships Between Genito-Pelvic Pain/Penetration Disorder, Sex Guilt, and Religiosity Among College Women in the U.S., The Journal of Sexual Medicine, Volume 18, Issue 4, April 2021, Pages 770–782, https://doi.org/10.1016/j.jsxm.2021.02.003 Meana M, Fertel E, Maykut C. Treating genital pain associated with sexual intercourse. In: Peterson ZD, ed. The Wiley Handbook of Sex Therapy. Chichester: Wiley Blackwell; 2017:98–114 -- 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. PS - Check out our goodies! Stickers, therapy trackers, and more available via our Shop!

Extended Exhaling: Invoking a Relaxation Response

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Inhale. Exhale. The rhythm of our breath is more than just a biological necessity – it's a tool that can influence our body's response to stress and promote a state of relaxation. One technique that's gaining attention for its calming effects is "extended exhale breathing." By exhaling for a slightly longer duration than inhaling, you can activate the parasympathetic nervous system, leading to a cascade of physiological responses that support relaxation and tranquility. Let's explore how this simple yet impactful technique works and why it's catching the attention of both ancient practices and modern research.   When we exhale for a longer period than we inhale, we engage the parasympathetic nervous system. This part of our autonomic nervous system is often dubbed the "rest-and-digest" mode – it's responsible for slowing down our heart rate, reducing blood pressure, and creating an overall sense of calm. The vagus nerve, a vital player in this system, gets stimulated during an extended exhale. This stimulation triggers a series of responses that culminate in a state of relaxation. Imagine it as a switch that shifts your body from the stress-driven "fight-or-flight" mode to a more serene and restful state.   Recent studies have delved into the effects of different breathing patterns on heart rate variability (HRV), a marker of autonomic nervous system activity. Two studies conducted by Bae et al. (2021) and Laborde et al. (2021) caught the essence of extended exhale breathing in action. The results echoed what yogis have been advocating for centuries – that a prolonged exhale duration correlates with heightened parasympathetic activity and increased HRV. Essentially, this means that individuals who exhale for a longer duration than they inhale exhibit greater signs of relaxation.   These are small studies that provide a scientific glimpse into the power of extended exhale breathing. Yet, the findings lend support to the claims rooted in ancient practices like yoga. The yoga community has long advocated for the benefits of conscious breathing techniques, and modern research is beginning to validate their wisdom.   So, how can you tap into this technique for your well-being? It's simple. During deep breathing exercises, pay attention to the length of your exhale. Aim to make it slightly longer than your inhale. You don't need a timer; just allow your breath to flow naturally, extending the exhale gently. As you do this, you're activating the parasympathetic nervous system, invoking a relaxation response. For those of you with muscle tension and pain-related issues like GPPPD, extended exhaling can be a useful strategy to assist with invoking a relaxation response prior to, and during, physical examinations or dilation therapy. Best of all - it’s a tool you can take with you wherever you go. You’ve got this!   (PS - Don't forget you can access our free eBook guide to managing physical examinations here ).   References:   Bae, D., Matthews, J. J., Chen, J. J., & Mah, L. (2021). Increased exhalation to inhalation ratio during breathing enhances high‐frequency heart rate variability in healthy adults. Psychophysiology, 58(11), e13905.   Laborde, S., Iskra, M., Zammit, N., Borges, U., You, M., Sevoz-Couche, C., & Dosseville, F. (2021). Slow-paced breathing: Influence of inhalation/exhalation ratio and of respiratory pauses on cardiac vagal activity. Sustainability, 13(14), 7775.  

B.R.A.I.N: Your tool for maximising consent in medical settings

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In the world of medical procedures and treatments, informed consent stands as a pillar of patient-centred care. It's the process through which individuals receive all necessary information about a proposed procedure or treatment before giving their consent. This practice ensures that patients are well-informed, actively involved in their healthcare decisions, and empowered to make choices that align with their values and preferences. Informed consent is relevant regardless of the procedure, but it's particularly important when there is risk of pain or adverse outcomes, or jeopardises your privacy. In this context, the B.R.A.I.N. acronym becomes a valuable tool, guiding individuals through the key aspects they should consider before providing consent. Let's delve into what informed consent entails and why it holds paramount importance: Benefits: This refers to understanding the potential positive outcomes or advantages of the proposed procedure or treatment. It involves asking questions like "What benefits can I expect?" and "How will this improve my condition or quality of life?" Risks: It is important to be aware of the potential risks or complications associated with the procedure or treatment. This involves asking questions like "What are the possible side effects or risks involved?" and "Are there any long-term implications I should be aware of?" Alternatives: Exploring alternative options is crucial to make an informed decision. It involves asking questions like "Are there alternative treatments or procedures available?" and "What are the pros and cons of each option?" Intuition: Trusting your instincts and considering your personal values and preferences is an essential part of the decision-making process. It involves asking questions like "How does this align with my beliefs and values?" and "What does my gut feeling tell me about this decision?" Nothing: It is essential to know that choosing not to proceed with a procedure or treatment is a valid option. This involves understanding the implications of not undergoing the recommended procedure and asking questions like "What happens if I choose not to proceed with this treatment?" By applying the B.R.A.I.N. acronym, individuals can engage in meaningful conversations with their healthcare providers, ensuring that they have a comprehensive understanding of the benefits, risks, alternatives, and their own intuition before making a fully informed decision about their healthcare. Through informed consent, individuals become active participants in their well-being, fostering a collaborative and patient-centred approach to healthcare decisions.

Decoding GPPPD: 6 Telltale Signs of Genito-Pelvic Penetration/Pain Disorder

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Meet Sally*, a 20 year-old woman with Genito-Pelvic Penetration/Pain Disorder or GPPPD. (*Sally is a fictional character based on a typical presentation). This condition causes persistent or recurrent pain in her pelvic region during daily activities. Here are six common signs of GPPPD:   Pain with Tampons: For Sally, using tampons has always been a painful experience, and some days it is physically impossible. This has led to anxiety and avoidance of tampon use altogether.   Fear of Pain: Sally's fear of pain overwhelms her with anxiety, tension, and anticipatory distress before engaging in sexual activities or undergoing gynaecological examinations.  She is beginning to avoid intimate relationships.    Pain with Intercourse: Dyspareunia, or pain during sexual intercourse, adds to Sally's distress. The pain she feels ranges from a dull ache to sharp and intense stabs.   Painful Pap Smears: Sally finds routine gynaecological examinations, like Pap smears, painful. The physical pressure applied during a pelvic exam triggers pelvic pain and distress.    Feeling of a Barrier: Sometimes Sally experiences the sensation of a physical barrier, or wall of muscle, blocking the way when trying to use a tampon or attempting sex.    Emotional Distress and Impairment: Beyond the physical symptoms, GPPPD takes a toll on Sally's emotional well-being. Coping with chronic pain, fear, and avoidance behaviours leads to increased levels of anxiety, depression, and feelings of isolation. Sally's daily activities, work, and relationships are disrupted, and it’s impacting her overall quality of life.   Recognising the signs of Genito-Pelvic Penetration/Pain Disorder (GPPPD) is vital for early detection and intervention. If you or someone you know experiences pain like this, seeking professional help from healthcare providers specialising in sexual health is crucial. GPPPD is a medical condition that can be effectively treated through a multidisciplinary approach, involving physiotherapy, psychology, and gynaecology services. By working closely with healthcare professionals experienced in GPPPD, individuals can access tailored treatment plans, and learn coping strategies. You've got this!