Genito Pelvic Pain Penetration Disorder involves pain and tightening during attempted penetration. Treatment is available.

Genito Pelvic Pain Penetration Disorder (GPPPD) is a medical condition that affects the pelvic floor muscles around the vagina. This disorder causes your muscles to contract or tighten whenever you attempt penetration.

GPPPD is in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). This text explains that the muscle contraction in this disorder is involuntary, and the recurrence sometimes has an underlying cause.

The disorder combines dyspareunia and vaginismus, which involves painful sex and vaginal muscle spasms. It prevents penetration by triggering tension and causing varying degrees of pain, from mild to intense.

The levels of pain aren’t the only varying factor, either. Some people with this disorder can insert a tampon but not have vaginal intercourse, while others can’t use tampons. Learning more about it and your treatment options can help.

GPPPD is a sexual pain disorder that affects nearly 15% of women in North America (DSM-5-TR). It is a sexual pain disorder involving genital or pelvic pain. GPPPD involves a few different subtypes, including:

  • Early-onset: This type occurs with the persistence of pain during attempted penetration. It includes the first instance and all that follow.
  • Late-onset: When the disorder reaches late-onset, you can experience vaginal pain after physical activity. It will still occur during penetration, too.
  • Situational: With this type, the pain varies by situation. Sometimes it’s triggered by specific movements or objects, like being able to insert a tampon but not being able to have intercourse.

GPPPD symptoms

People with this disorder might not exhibit all potential symptoms, and you might only experience one. The symptoms of GPPPD include:

  • involuntary tightening of the pelvic floor muscles
  • pain or difficulty with attempted vaginal penetration during sexual activity
  • fear or anxiety in anticipation of penetration
  • decreased desire for sexual intimacy
  • tension, pain, or burning

GPPPD disorder can cause stress since it alters how you experience intimacy and can make it more challenging to conceive.

Additionally, if you experience GPPPD, you may also experience:

However, GPPPD can also bring you and your partner closer together since it may spark some vulnerable conversations about sex and intimacy.

Determining the underlying cause of this sexual dysfunction can help you overcome the condition. There are many causes, including:

Health conditions

Some health conditions cause GPPPD, including, but not limited to:

Inflammation or injury

Vaginal muscle inflammation or vulva injury can be underlying causes. However, there are other reasons that it can occur. Inflammation can occur because of vaginal infections or other gynecological conditions.


Vaginal dryness leads to pain and penetration occurring together. It often occurs after menopause but can happen before that for many reasons.

Past trauma

Having a traumatic experience can cause involuntarily tensing muscles during attempted penetration. One traumatic experience that can cause GPPPD is intense pain during childbirth. Additionally, child and sexual abuse victims may develop the disorder.


Additionally, having an increased number of nerve fibers can lead to painful penetration. The increased number leads to overly sensitive nerves. It can cause all or one of your senses to intensify, sometimes causing pain.

Negative ideas about sex

If someone believes that sexual desire is wrong, they might experience pain and discomfort when engaging in sex. This cause usually means tampons feel okay, but sexual penetration is painful. Additionally, someone who believes pain will hurt might experience tensing muscles during penetration.

For a GPPPD diagnosis, the symptoms must continue for at least six months. They also must cause distress and not be related to another condition, medication, or substance use. A doctor will check the pelvic floor for dysfunction, but it can be hard for those that can’t handle penetration.

You can’t cure GPPPD, but you can overcome it and experience decreased pain levels. Identifying the cause is the first step to treating the disorder. Once you know the cause of the issue, you can develop and maintain a treatment plan.

Consult a doctor

Women experiencing GPPPD may want to consult a professional for diagnosis. Self-help techniques might help, but it’s likely best to get guidance from a doctor. They can also help you rule out other potential causes of your symptoms.

Engage in gentle intercourse

If the problems arise only during intercourse, being gentle might help. It doesn’t help everyone, but it can make all the difference for some.

You can also play around with other forms of sex and find out what works best for you and your partner. There’s no one right way to be intimate.

Try pelvic floor exercises

With a good routine and dedication, exercise can help you treat GPPPD. Consider pelvic floor exercises, including:

  • kegel’s
  • heel slides
  • marches or toe taps
  • yoga

Speak with a therapist

If the cause is psychological, it can help if you go to therapy. A professional can help you improve your psychological well-being, reduce fear, and overcome trauma. It also allows you to respond to anxiety in positive ways.

Practice good hygiene

Practicing good vaginal hygiene is essential and isn’t all about washing. Consider wearing cotton underwear and only using a mild soap when washing. Avoid over-the-counter vaginal deodorants and scented lubricants.

Genito pelvic pain penetration disorder may take some lifestyle changes but you still can have a healthy sex- and romantic life. It just may take some creativity and patience.

While you can’t cure GPPPD, you can treat it and overcome the issues. It’s likely best to consult with a doctor to determine what treatment plan is best for your individual needs.

Treatment may also include therapy. Whether your pain is psychological or physical (or both), speaking with a therapist about what you’re experiencing can be helpful for protecting your mental health. They can also help you navigate rethinking what sex is supposed to look like.

No matter what treatment plan you choose, remember you are not alone.