The aim of the investigation was: (1) to enhance the understanding of physiotherapists and other healthcare professionals of the symptoms and causes of GPPPD and (2) to offer insight into the healthcare that is offered to Icelandic women affected by this condition by healthcare professional other than women’s health physiotherapists.
A qualitative study was conducted, involving semi-structured interviews with eight women who met the diagnostic criteria for GPPPD, and had undergone treatment by a women‘s health physiotherapist. Thematic analysis was applied to the collected data to identify key themes along with transformation of some of the data to a quantitative form.
Two distinct themes were identified during data analysis regarding the first aim: (1) symptoms and (2) causes. The most common symptoms were pain during or after intercourse or difficulties with vaginal penetration, as well as urinary incontinence, frequent urination, and pain in the lower back, pelvic or abdominal area. The most common causes were pain disorders in the abdominopelvic cavity (62,5%), stress (50%) and sexual abuse (38%). In response to the second aim, five distinct themes were identified: (1) healthcare professional selection, (2) positive experiences with healthcare services, (3) negative experiences with healthcare services, (4) negative implications, and (5) education-related social media and personal knowledge. Participants most commonly sought help from gynecologists, primary care physicians and general physiotherapists. Negative experiences with healthcare services were more pronounced than positive ones. These included a lack of listening and knowledge about women‘s health, an overemphasis on appearance of body parts or tissues rather than function, and a failure to refer clients for further examination. This commonly led to delayed diagnosis. Furthermore, negative experiences were to a greater extent associated with male professionals. Positive experiences were related to practioners’ extensive knowledge of pelvic floor disorders, positive interactions and service provided by female healthcare professionals. Negative implications from a lack of support and failure to provide early and appropriate intervention were mainly four-fold: (1) normalization of symptoms, (2) mental distress and shame (3) fear of symptoms and (4) isolation and self-doubt. Most of the participants were referred to a women‘s health physiotherapist by a healthcare provider, while two sought help after seeing educational material on social media, and only one did so based on her own knowledge of pelvic floor disorders.
The clinical manifestation of GPPPD is multifaceted and complex. The symptoms associated with the conditions involve multiple organ systems, and the causes are often complex in each case. Negative experiences with healthcare services are common, often related to inadequate understanding of women‘s health issues and a prolonged time to diagnosis. Future studies could examine the experiences of the services and treatment provided by women’s health physiotherapists in the treatment of GPPPD.
There is a need for more open and public dialogue about the issue, including education of healthcare professionals and increased interdisciplinary collaboration.
Women’s health
Experience of healthcare services
