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CC BY 4.0 · Rev Bras Ginecol Obstet 2018; 40(12): 787-793
DOI: 10.1055/s-0038-1675805
Review Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

Perturbação de dor Gênito-pélvica e da penetração: revisão dos fatores associados e abordagem geral
Ana Dias-Amaral
1   Psychiatry and Mental Health Clinic, Centro Hospitalar de São João, Porto, Portugal
,
André Marques-Pinto
2   Department of Urology, Centro Hospitalar do Porto, Porto, Portugal
› Author Affiliations
Further Information

Publication History

26 April 2018

28 September 2018

Publication Date:
14 November 2018 (online)

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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 perturbação 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 etiologia e o tratamento da PDGPP, tendo em conta, principalmente, os aspetos cognitivos e as abordagens de inspiração psicoterapêutica cognitivo-comportamental. Para tal, foi efetuada uma revisão não sistemática dos artigos indexados às bases de dados Medline, Scopus e Web of Science, usando os termos: dor pélvica; dispareunia; vaginismo; vulvodinia; e terapia cognitiva. No total, foram incluídos 36 artigos discutindo a etiologia, diagnóstico e tratamento da PDGPP. Neste artigo, proporcionamos uma revisão do tratamento da PDGPP baseado em fatores biológicos, psicológicos e relacionais, enfatizando os últimos dois. Também resumimos as opções de tratamento médico disponíveis, e disponibilizamos estratégias para abordar os fatores desencadeantes e de manutenção tanto nas doentes quanto nos seus parceiros. Os profissionais devem estar familiarizados com os fatores subjacentes a este problema, e devem ser capazes de oferecer sugestões úteis para ajudar o casal a quebrar o círculo vicioso de medo e evitamento associado à PDGPP.

Keywords

dyspareunia - vaginismus - vulvodynia - cognitive therapy - behavioral therapy

Palavras-chave

dispareunia - vaginismo - vulvodinia - terapia cognitiva - terapia comportamental
 

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