Genito-pelvic pain/penetration disorder (GPPPD) is a condition that can cause significant distress, affecting activities like tampon use, gynecological exams, and sexual intercourse. It involves pain, muscle tightness, and anxiety related to vaginal penetration and may lead to reduced sexual desire and emotional challenges like anxiety and depression. Despite its prevalence, diagnosing and treating GPPPD has been difficult due to the lack of effective assessment tools.

To address this issue, researchers developed the Vaginal Penetration Skills Scale (VPSS), a self-report questionnaire that evaluates vaginal penetration skills in both sexual and nonsexual contexts. The VPSS assesses three key areas: nonsexual self-exploration, nonsexual vaginal penetration, and sexual vaginal penetration. By identifying pain, fear, or discomfort, it helps clinicians understand the specific challenges individuals face with penetration.

Unlike previous tools that focus only on behavioral outcomes (e.g., successful penetration), the VPSS assesses physical, emotional, and cognitive aspects of vaginal penetration. It provides valuable insights for both clinical practice and research, enabling better screening, diagnosis, and treatment planning for GPPPD. This scale marks a step forward in helping individuals understand and overcome the barriers to comfortable and confident vaginal penetration.

Researchers from Brazil created the VPSS in four phases. First, they reviewed 40 medical records, conducted an extensive literature review, and analyzed existing tools on female sexual pain and function to draft an initial set of 50 items to be included in the scale. The items addressed gaps in existing research, focusing on fear, anxiety, pain, and penetration capabilities.

Second, 10 experts revised and refined the items for clarity and representation. Third, they tested the scale through focus groups, gathering feedback to improve understandability and reduce redundancy, resulting in a refined 45-item version. Finally, professional translators adapted the scale from Brazilian Portuguese into English for broader use, though further cultural validation is needed.

A total of 399 Brazilian women with and without GPPPD symptoms were recruited to test and validate the VPSS. Through this real-world application, the researchers were able to refine the initial 45 items of the VPSS to 29 items for better clarity and relevance. The final VPSS model demonstrated excellent validity and reliability.

A shorter version, the VPSS-SF11, was also created for easier use. It maintains the scale’s three-factor structure and has been shown to effectively distinguish between individuals with and without GPPPD. A score of 45 or lower on the VPSS-SF11 indicated GPPPD with high sensitivity (90.5%) and specificity (80.1%).

The VPSS is valuable in both clinical and research settings. It helps doctors create personalized treatment plans and can track progress in therapy. Future studies are needed to further refine the tool and explore its use in more diverse populations. Ultimately, the VPSS aims to improve the diagnosis and treatment of GPPPD, enhancing the quality of life for those affected by this condition.

References:

• Maldonado, M., Figueira, G. L., Nardi, A. E., & Sardinha, A. (2024). The Vaginal Penetration Skills Scale (VPSS): A paradigm shift in genito-pelvic pain/penetration disorder screening, assessment, and stratification. The Journal of Sexual Medicine, 21(12), 1178–1192. https://doi.org/10.1093/jsxmed/qdae124