Genito-Pelvic Pain/Penetration Disorder Presenting as an Unconsummated Marriage Managed in Japanese Primary Care.

BACKGROUND: Genito-pelvic pain/penetration disorder (GPPPD) may present as unconsummated marriage and receive less attention when pregnancy is prioritized. CASE: A 39-year-old woman and her husband presented after 5 years without penovaginal intercourse despite fertility treatment. Clinical history supported GPPPD. Primary care included biopsychosocial assessment, psychoeducation, and couple support. Stepwise care included paced breathing, pelvic floor relaxation stretches, lubricant, graded insertion, and vaginal dilation. Intercourse was achieved after 8 months, patient-rated overall satisfaction rose from 0 to 85/100, and she had a child. CONCLUSION: Family physicians may support couples with GPPPD using biopsychosocial, stepwise care when specialist services are limited.