Abstract
BackgroundPersistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) is a highly distressing yet poorly understood condition characterized by persistent genito-pelvic sensations, often described as “genital arousal,” which occur in the absence of sexual desire. PGAD/GPD is associated with significant impairment in psychosocial and daily functioning; however, there are currently no empirically validated treatment algorithms for PGAD/GPD. Pelvic floor physical therapy exercises have been found to be effective at reducing other forms of genito-pelvic discomfort, such as vulvodynia, and may also be beneficial to those experiencing PGAD/GPD. Many individuals with PGAD/GPD report difficulty finding a health care provider who is knowledgeable about PGAD/GPD; therefore, pelvic floor education and exercises in an online format may have the potential to reach more individuals in need.ObjectiveThis study examined the feasibility of an online pelvic floor group education program; descriptively assessed outcomes related to distress, discomfort, catastrophizing, and mood; and obtained feedback from participants in order to inform the development of improved online group programs.MethodsFourteen women with current symptoms of PGAD/GPD attended an online, 8-session pelvic floor group education program. Participants completed questionnaires of symptoms (ie, symptom distress, discomfort) and psychosocial well-being (ie, depression, anxiety, symptom catastrophizing) prior to the group sessions (Time 1), immediately after the final group session (Time 2), and 6 months following the final group session (Time 3). Participants also completed an anonymous feedback questionnaire immediately following the group program.ResultsOverall, participants who attended a larger number of the group sessions (>5 sessions, n=7) appeared to report lower baseline (Time 1) symptoms and psychosocial impairment than those who attended fewer sessions (<5 sessions, n=7). A pattern of small improvements was seen following the group sessions on symptom and psychosocial outcomes. In the feedback questionnaire, breathing and relaxation exercises were described to be the most helpful home practice exercises, and participants rated sessions on (1) the relationship between emotions and PGAD/GPD symptoms and (2) relaxation exercises to be the most helpful. A number of barriers to participation in the group program were also identified, including comorbid health concerns and lack of personal time to complete the program/exercises.ConclusionsOnline interventions provide an opportunity to reach international participants who may otherwise struggle to access a knowledgeable provider for their PGAD/GPD symptoms. Addressing barriers may help to increase participants’ abilities to engage in the program. Future programs may seek to integrate a greater focus on relaxation strategies and cognitive-affective strategies for managing PGAD/GPD symptoms.
Highlights
Persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) is a highly distressing yet misunderstood condition characterized by distressing genito-pelvic sensations often described as “genital arousal” [1]
Online interventions provide an opportunity to reach international participants who may otherwise struggle to access a knowledgeable provider for their PGAD/GPD symptoms
On validated questionnaires with more than 10 items (CES-D, State-Trait Anxiety Inventory (STAI), modified version of the Pain Catastrophizing Scale (M-PCS), Female Sexual Distress Scale – Revised (FSDS-R)), if fewer than 15% of the items were missing for each individual, missing values were replaced with the individual’s mean response on that questionnaire
Summary
Persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) is a highly distressing yet misunderstood condition characterized by distressing genito-pelvic sensations (ie, dysesthesias) often described as “genital arousal” [1]. Part of the negative experience of these sensations is due to their extreme nature: the sensations are most often prolonged, persistent, and difficult—if not almost impossible—to stop [2]. They are commonly described as painful [1,3]. Persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) is a highly distressing yet poorly understood condition characterized by persistent genito-pelvic sensations, often described as “genital arousal,” which occur in the absence of sexual desire. Many individuals with PGAD/GPD report difficulty finding a health care provider who is knowledgeable about PGAD/GPD; pelvic floor education and exercises in an online format may have the potential to reach more individuals in need
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