Questionnaire For Genito-Pelvic Dysethesia (GPD)

The Questionnaire for Genito-Pelvic Dysesthesia (GPD) is a clinical assessment tool used to evaluate symptoms of Persistent Genital Arousal Disorder (PGAD), now formally termed Genito-Pelvic Dysesthesia. This condition is characterized by unwanted, intrusive sensations of genital arousal (such as throbbing or a feeling of being on the verge of orgasm) that occur without sexual interest or desire. The 2021 International Society for the Study of Women's Sexual Health (ISSWSH) consensus paper by Goldstein et al. acts as a clinical roadmap for diagnosing and treating PGAD/GPD. It formalizes the "Questionnaire for GPD" not as a single "score" (like a test score in school), but as a diagnostic algorithm used to identify the root cause of the distress.

The Five Diagnostic Criteria (The "Screening" Phase)

Before scoring the severity or location, a patient must meet five mandatory criteria to be diagnosed with PGAD/GPD. If you were filling out the questionnaire, these are the "Yes/No" gates:

• Presence of Arousal Sensations: Persistent or recurrent unwanted/intrusive sensations (e.g., tingling, throbbing, swelling).
• No Sexual Desire: The sensations are not accompanied by feelings of sexual interest or "being in the mood."
• Duration: Symptoms must have persisted for at least 3 to 6 months.
• Distress: The sensations must cause significant clinical distress, anxiety, or depression.
• Dysesthesia: The sensations may include "off" feelings like burning, twitching, or the feeling of being "on the verge" of an orgasm.

How the GPD Breakdown Works (The "5-Region" Map)

The "Questionnaire" often refers to the 5-Region Diagnostic Algorithm described in the paper. Instead of a total numerical score, this tool "scores" you by placing your symptoms into one or more of five categories to determine the cause:

The "score" tells your doctor:

• Intensity & Distress: How much is this ruining your quality of life?
• Location (Regions): Is this coming from your spine, your nerves, or your skin?
• Cognitive Impact: How much anxiety or "fear of the sensation" is contributing to the flare-ups?

Assessment Configuration

The GPD is divided into three critical sections:

1. Sensation Characterization: The questionnaire lists 16 distinct descriptors (with space for "Other") to help patients specify the exact quality of their atypical sensations. Patients rate each on a scale of 0 (None) to 3 (Severe).

• Arousal-Mimicking Sensations: Descriptors like Engorgement, Throbbing, and Warmth capture the intrusive "arousal" aspect of the disorder.
• Neuropathic Sensations: Descriptors such as Electric Shocks, Buzzing, Burning, and Stabbing point toward nerve-related dysfunction, often associated with the pudendal or sacral nerves.
• Functional/Physical Descriptors: Specific terms like Sitting on Rocks, Twitching, and Pressure Internally help clinicians identify potential musculoskeletal or structural triggers, such as pelvic floor hypertonicity.
• The user will have the option to free text entry up to three additional symptoms that can also be rated from 0 to 3. These additional rated symptoms will be included in the total symptom score.

2. Bother and Impact

The second section uses a number scale from 0 to 10 for patients to indicate the degree of bother they experience, ranging from None (0) to Worst (10). This is a crucial metric, as high levels of distress are common in GPD and can significantly impact daily functioning, such as driving or working.

3. Overall Intensity

The final section provides a 6-point categorical scale (0–5) to rank the current overall intensity of the sensations:

• 0: No unwanted sensations.
• 1–2: Mild to Discomforting.
• 3–5: Distressing, Horrible, or Excruciating.

Results

• Total Symptom Score: Sums the rating of 16 distinct descriptors along with any additional rated symptoms entered by the user.
• Bother Score
• Overall Intensity Score