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If you missed some, catch up here. GPPPD is a combination of painful sex dyspareunia and involuntary vaginal muscle spasms vaginismus. If these symptoms sound familiar, I recommend making an appointment with a gynecologist. They can advise you on treatment and other next steps. If your gynecologist diagnoses GPPPD, they may refer you to a physical therapist who specializes in the pelvic floor and a sex therapist. Sex therapy can help you learn how to manage and overcome the emotional symptoms of GPPPD, while physical therapy can teach you how to use vaginal dilators to help your pelvic floor muscles relax.

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Vaginismus is an involuntary tightening of the pelvic floor muscles when a woman attempts to insert something into her vagina. It causes an intense burning pain and can make penetration impossible: The vagina may completely clamp up, blocking entry, as if it were a brick wall. Factors that can cause or exacerbate vaginismus include anxiety, past sexual trauma, or a fear of intercourse sometimes stemming from inadequate or nonexistent sex ed. There can also be physical explanations, like complications from pelvic trauma or cysts. However, these statistics are fuzzy because sufferers are often too scared to seek treatment or are misdiagnosed when they do.