Associated Features Supporting Diagnosis 
Genito-pelvic pain/penetration di sorder is frequently associated with other sexual dysfunc-
tions, particularly reduced sexual desire and interest (female sexual interest/arousal disor-
der). Sometimes desire and interest are preserved in sexual situations that are not painful or
do not require penetration. Even when indivi duals with geni to-pelvic pain/p enetration dis-
order report sexual interest/mot ivation, there is of ten behavioral avoidance of sexual situ-
ations and opportunities. Avoidance of gynecological examinations despite medical
recommendations is also frequen t. The pattern of avoidance is si milar to that seen in phobic
disorders. It is common for women who have no t succeeded in having sexual intercourse to
come for treatment only when they wish to conceive. Many women wi th genito-pelvic pain/
penetration disorder will experience associated  relationship/marital problems; they also of-
ten report that the symptoms significantly diminish their fee lings of femininity. 
In addition to the subtype “lifelong/acquired,” five factors should  be considered dur-
ing assessment and diagnosis of genito-pelvi c pain/penetration di sorder because they
may be relevant to etiology and/or treatmen t: 1) partner factors (e.g., partner’s sexual
problems, partner’s health status); 2) relationship factors (e.g., poor communication, dis-
crepancies in desire for sexual activity); 3) individual vulnerability factors (e.g., poor body
image, history of sexual or emotional abuse), psychiatric comorbidity (e.g., depression,
anxiety), or stressors (e.g., job loss, bereavemen t); 4) cultural/religious factors (e.g., inhi-