Persistent Genital Arousal Disorder

Symptoms, Causes, and Treatment of PGAD

Persistent genital arousal disorder (PGAD) is a recently identified disorder that is still being studied and defined. It refers to chronic feelings of genital arousal (commonly referred to as “pelvic tension”) that are unrelated to any form of sexual stimulation, do not resolve on their own, and may cause pain or discomfort to the affected person.

In the past, the condition was known as persistent sexual arousal syndrome (PSAS).

The change in name was suggested because it is technically a genital rather than a sexual problem. Although PGAD was first documented in the clinical literature in 2001, it is likely that women have been suffering silently for many years.

Researchers are still in the process of describing this phenomenon, and there are no uniform criteria for what is and is not PGAD. However, the first article describing PGAD suggests that it should include the following.

Features

• A physiological reaction comparable to sexual arousal (such as genital tenderness or swelling) that lasts a long time (hours to days) and does not go away on its own.
• Physical signs have nothing to do with sexual arousal or desire.
• Even non-sexual events or nothing at all can trigger physical sensations.
• The signs of arousal may persist after orgasm or may take many orgasms to disappear.
• The sensation is considered intrusive and unwanted and can cause considerable distress if it persists.

A recent study included a new feature: the intense experience of spontaneous orgasms that are not triggered by sexual stimulation.

PGAD causes

Surprisingly, no single reason has yet been found. Researchers have postulated a variety of explanations, including neurological, vascular, physical, pharmacological, and psychological factors.

Several articles and anecdotal reports have suggested a link between SSRIs and the occurrence of PGAD. A recent case study found an association between phytoestrogen intake and breast cancer risk. However, at this time, there are insufficiently documented cases beyond informed guesses.

Treatment

Sandra Lieblum, one of the authors of the original study on persistent sexual arousal syndrome, presents four possible therapeutic options in a report on PGAD. No single therapy has yet been discovered, and it is possible that the treatments will not completely eradicate the problem.

However, they can help relieve pain, stress and discomfort. There are several treatment options, including:

• Psychoeducation and support are available.

Knowing that you are not alone in your feelings and that they are not “just in your head” or something to be “grateful” for can help reduce stress and even symptoms.

• Identify the root causes of the problem.

Certain activities make pain or discomfort worse for certain women. Finding out what your triggers are can help you avoid them.

• Massage the pelvis.

Stretching and pelvic massage can help relieve pain by relaxing the pelvic floor muscles and raising awareness of stress and tension. In this case, a physical therapist or other health care provider with experience can help you with pelvic discomfort.

• Medications.

Given that various medications have been linked to the development of PGAD in some women, it is understandable that they may not want treatment. On the other hand, there are women who take a “whatever works” attitude because the experience is so uncomfortable.
There is no single medication that Lieblum recommends, and finding one that works is a trial-and-error process that you should discuss with your doctor.

What is the prevalence of PGAD?

The survey created by the researchers has now been completed online by more than 400 women, while the original study, which evaluated data from women, included 103 women (as of October 2006).
Although chronic genital arousal is probably uncommon, given the lack of importance our culture places on sexual health, it’s possible that the disorder is more common than researchers believe.

The symptoms of PGAD, while uncommon, can be extremely distressing for women, significantly affecting their sexuality and their overall lives. Hopefully, science will continue to look into this issue and women will speak up instead of suffering in silence.

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Sources:

• Amsterdam, A., Abu-Rustum, N., Carter, J., Krychman, M. “Persistent Sexual Arousal Syndrome Associated with Increased Soy Intake” The Journal of Sexual Medicine Vol. 2, No. 3 (2005):338-40.
• Goldmeier, D., Bell, C., Richardson, D. “Withdrawal of Selective Serotonin Reuptake Inhibitors (SSRIs) May Cause Increased Atrial Natriuretic Peptide (ANP) and Persistent Sexual Arousal in Women?” The Journal of Sexual Medicine Vol. 3, No. 2 (2006): 376.
• Leiblum, S.R. “Persistent Genital Arousal Disorder: What It Is and What It Isn’t” Contemporary Sexuality.Vol. 40, No. 10 ( 2006): 8-13.
• Leiblum, S., Brown, C. and Wan, J. “Persistent Sexual Arousal Syndrome: A Descriptive Study” The Journal of Sexual Medicine Vol. 2, No. 3 (2005): 331-337.
• Leiblum, S.R. & Nathan, S.G. “Persistent Sexual Arousal Syndrome: A Newly Discovered Pattern of Female Sexuality” Journal of Sex and Marital Therapy. Vol. 24, No. 4 (2001): 365-380.