Genito-Pelvic Pain/Penetration Disorder – A New Mental Health Diagnosis
Sexual Dysfunction Basics
Sexual dysfunction is the term doctors use to describe any alteration in male or female sexual response that results in a significant decrease in sexual satisfaction, either within the affected individual or that individual’s sexual partner. The Cleveland Clinic notes that these alterations come in four basic forms, known as desire, arousal, orgasm and pain disorders. Men affected by some form of sexual dysfunction typically have problems doing such thing as developing or sustaining an erection during sex, ejaculating during sex, or controlling when an ejaculation occurs. Women affected by some form of sexual dysfunction typically have problems doing such things as generating an interest in sex, developing sufficient vaginal lubrication for sexual activity, relaxing the vaginal muscles enough for sex to occur, or orgasming during sex.
According to the guidelines set forth in the now-outdated fourth edition of the Diagnostic and Statistical Manual, dyspareunia is a sexual pain disorder that can appear in both men and women. People affected by this condition develop genital pain during all or some instances of sexual intercourse; they also experience some sort of substantial mental anguish or relationship disruption as a result of their condition. In addition, affected individuals must not have some other mental or physical issue that explains their genital pain, such as substance use problems, a medical condition, or any psychiatric problem other than sexual dysfunction. Some males and females experience dyspareunia from the very start of their sexual lives, while others develop the condition after a period of pain-free involvement in intercourse.
The fourth edition of the Diagnostic and Statistical Manual (DSM IV) defines vaginismus as a sexual pain disorder that only appears in women. People affected by this condition experience an unusual spasming in their vaginal muscles during some or all instances of sexual intercourse; this spasming effectively narrows the vaginal opening and impedes penetration. As is true with dyspareunia, affected individuals may develop this problem every time during intercourse or only some of the time. Like the criteria for dyspareunia, the criteria for vaginismus also state that the condition must cause either mental anguish or relationship disruption. In addition, it must not result from some other physical or mental/psychological problem. Some women experience vaginismus from the beginning of their sex lives, while others only develop the disorder after a period that’s free from any form of unusual vaginal contraction.
Genito-Pelvic Pain/Penetration Disorder
Genito-pelvic pain/penetration disorder gained official status in May 2013 with the publication of the Diagnostic and Statistical Manual’s fifth edition, known as DSM 5. The American Psychiatric Association (APA) created this new condition because dyspareunia and vaginismus (the two conditions it replaces) appear together very commonly in affected women and produce symptoms that, while different in their strict definitions, are very difficult to tell apart in real life. The APA feels that establishment of genito-pelvic pain/penetration disorder gets to the heart of the matter while reducing any possibility for a confused or confusing diagnosis in affected individuals.
Genito-pelvic pain/penetration disorder shares some of the updated criteria now established for all conditions in DSM 5 defined as sexual dysfunctions. According to the guidelines outlined by these updated criteria, doctors must now establish that symptoms of sexual dysfunction are present for a minimum of half a year before making a diagnosis. They must also determine and note the severity of symptoms in each patient. In addition, the criteria established for genito-pelvic pain/penetration disorder and other forms of sexual dysfunction no longer include any distinction between symptoms that only appear in certain sexual situations and symptoms that appear in all sexual situations. Underlying reasons for making these changes include a desire to limit the potential for overdiagnosis of sexual dysfunction, as well as a desire to separate normal, temporary fluctuations in sexual desire or performance from ongoing, potentially dysfunctional problems.