Female Genito-Pelvic Pain/Penetration Disorder: Review of the Related Factors and Overall Approach

Abstract Genito-pelvic pain/penetration disorder (GPPPD) can be an extremely bothersome condition for patients, and a tough challenge for professionals regarding its assessment and treatment. The goal of the present paper is to review the etiology, assessment, and treatment of GPPPD, especially focusing on the cognitive aspects of the disease and cognitive-behavioral treatment options, through a non-systematic review of articles indexed to the Medline, Scopus and Web of Science databases, using the following MeSH queries: pelvic pain; dyspareunia; vaginismus; vulvodynia; and cognitive therapy. Altogether, 36 articles discussing the etiology, diagnosis and management of GPPPD were selected. We provide an overview of GPPPD based on biological, psychological and relational factors, emphasizing the last two. We also summarize the available medical treatments and provide strategies to approach the psychological trigger and persisting factors for the patient and the partner. Professionals should be familiarized with the factors underlining the problem, and should be able to provide helpful suggestions to guide the couple out of the GPPPD fear-avoidance circle.Resumo A perturba ção de dor gênito-pélvica e da penetração (PDGPP) é uma patologia com elevado impacto no bem-estar das pacientes, e traduz-se num desafio diagnóstico e de tratamento para os profissionais que as acompanham. O objetivo deste artigo é rever a etiolog...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research

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The objectives of this study were to define the role for surgery in the treatment of chronic low back pain (cLBP) and to develop a new classification of cLBP based on the pattern of injury.HypothesisSurgery may benefit patients with cLBP, and a new classification based on the injury pattern may be of interest.MethodA systematic literature review was performed by searching Medline, the Cochrane Library, the French public health database (Banque de Données en Santé Publique), Science Direct, and the National Guideline Clearinghouse. The main search terms were “back pain” OR “lumbar” OR &...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
CONCLUSIONS: There is no evidence to support the superiority of sound therapy for tinnitus over waiting list control, placebo or education/information with no device. There is insufficient evidence to support the superiority or inferiority of any of the sound therapy options (hearing aid, sound generator or combination hearing aid) over each other. The quality of evidence for the reported outcomes, assessed using GRADE, was low. Using a combination device, hearing aid or sound generator might result in little or no difference in tinnitus symptom severity.Future research into the effectiveness of sound therapy in patients w...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Authors: Jarrell JF, Vilos GA, Allaire C, Burgess S, Fortin C, Gerwin R, Lapensee L, Lea RH, Leyland NA, Martyn P, Shenassa H, Taenzer P Abstract OBJECTIVE: To improve the understanding of chronic pelvic pain (CPP) and to provide evidence-based guidelines of value to primary care health professionals, general obstetricians and gynaecologists, and those who specialize in chronic pain. BURDEN OF SUFFERING: CPP is a common, debilitating condition affecting women. It accounts for substantial personal suffering and health care expenditure for interventions, including multiple consultations and medical and surgical t...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
CONCLUSIONS: The findings of this review offer clinical insight and reinforce the importance of psychosocial interventions in CNCP and opioid use disorders. However, little empirical data are available to guide practitioners in treating patients with CNCP who misuse opioid medications, and thus future research on integrated approaches, is needed. PMID: 30387858 [PubMed - in process]
Source: Journal of Opioid Management - Category: Addiction Tags: J Opioid Manag Source Type: research
Conclusion: ICBT for physical and psychological conditions in youth with chronic pain is a full potential therapy; it can be successful on clinically effects and socioeconomic benefits. However, only limited data supported the conclusion, we require further methodologically robust trials. Systematic review registration: PROSPERO CRD42017069811.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
Conclusions: The identification of the gaps in knowledge in the management of pain in elite athletes will provide a unified direction for the retrieval of information and further research that will provide reassurance, speed return to active sport, and benefit performance.
Source: Clinical Journal of Sport Medicine - Category: Sports Medicine Tags: General Review Source Type: research
We’re rather flighty beasts, us clinicians. From looking at the various ads for courses on the interwebs, it seems we’re all ready to jump on to the next newest thing. This same “what’s new” attitude is present in journals as well –  “these references are very old, are there newer ones you can use?” Here’s a question: what happens to the old stuff? Is it outdated and useless? Do really well-conducted studies have a “use-by” date? Are older therapies always less effective than the new ones? What if this urge to “refresh” means we do actually ...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Pain conditions Professional topics Research Cognitive Behavioural Therapy function Health pain research rehabilitation Therapeutic approaches Source Type: blogs
I’m not certain Theodore Roosevelt actually said that – but who cares?! It’s a great statement. For the person living with persistent pain, though, it can be the last thing you want to hear. After all, it’s tough enough getting up and just doing the normal things let alone challenge yourself! So… how can a health professional help? Let’s briefly recap. Self efficacy is the confidence I can do something successfully if I wanted to. It’s a robust predictor of many health behaviours including exercise, stopping smoking, eating healthily and coping well with persistent pain (Jackson, ...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Back pain Chronic pain Clinical reasoning Coping Skills Coping strategies Professional topics Research Resilience Science in practice biopsychosocial function healthcare pain management physiotherapy rehabilitation self effic Source Type: blogs
This article provides a brief description of the core characteristics of CBT and the transformation this therapeutic model has brought to our understanding and management of chronic pain. Current evidence on efficacy of CBT for chronic pain is then reviewed, followed by a critical consideration of the advantages and disadvantages of the new hybrid treatment approach that conceptualises and treats chronic pain in connection with its comorbidities. Recent progress made in the area of pain and insomnia is highlighted as an example to project therapeutic innovations in the near future.
Source: Progress in Neuro Psychopharmacology and Biological Psychiatry - Category: Psychiatry Source Type: research
Self efficacy. It’s a word bandied about a lot in pain management, and for a group of clinicians in NZ, it’s been a shock to find out that – oh no! They’re not supporting self efficacy with their patients very much! It means “confidence that if I do this under these conditions, I’ll be successful”. Self efficacy is part of Bandura’s social learning theory (click here for the Wikipedia entry) where he proposed that much of psychological treatment is driven by a common underlying mechanism: to create and strengthen expectations of personal effectiveness. Bandura recognised that...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Clinical reasoning Coping Skills Coping strategies Motivation Pain Pain conditions Professional topics Research Resilience Science in practice biopsychosocial Chronic pain function healthcare pain management rehabilitation Source Type: blogs
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