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Persistent Genital Arousal Disorder (PGAD)

Symptoms, Causes, and Treatment of Persistent Genital Arousal Disorder

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Updated March 30, 2009

Persistent genital arousal disorder (PGAD) is a newly described disorder that is not yet fully understood or defined. It refers to the experience of persistent feelings of genital arousal (often described as “pelvic tension”) that are not associated with sexual stimulation of any kind, that don’t go away on their own, and that cause the individual pain or distress.

The disorder was originally called persistent sexual arousal syndrome (PSAS) in the literature. The change in terminology was recommended because strictly speaking the problem is not sexual; it’s a problem with the genitals. While PGAD was first written about in the clinical literature in 2001, it is likely something that has been experienced by women for many years in silence.

PSAS Support is an excellent online support group for women experiencing persistent genital arousal.

Symptoms of Persistent Genital Arousal Disorder

Researchers are still describing this phenomenon and no criteria are agreed upon for what is and isn’t PGAD. But the first article to describe PGAD suggests that it should include the following features:
  • Experiencing physiological response similar to sexual arousal (such as genital sensitivity or engorgement) that lasts for an extended period of time (from hours to days) and does not go away on its own.
  • Physical signs are not related to feeling sexually excited or sexual desire.
  • Physical experience may be triggered by nonsexual events or by nothing at all.
  • Physical signs of arousal do not go away after orgasm, or may require multiple orgasms to go away
  • The experience is considered intrusive and unwanted; and when it persists, can create significant distress.

A more recent paper proposed an additional feature: The experience of spontaneous orgasms which are not brought on by sexual stimulation and are intense.

Causes of PGAD

Not surprisingly, no single cause has yet to be identified. Researchers have proposed everything from neurological to vascular to physical to pharmacological to psychological causes. Several papers and anecdotal reports have proposed a connection between SSRIs and onset of PGAD. A recent case study suggested a connection to dietary intake of phytoestrogens. But not enough documented cases offer anything other than educated guesses at this point.

Treatment

In a review of PGAD, Sandra Lieblum, one author of the original persistent sexual arousal syndrome article, outlines four different courses of treatment that may provide relief. No single treatment has emerged, and it may be that treatments do not completely eliminate the condition. But they may help reduce pain, stress, and discomfort. Treatment options include:
  1. Psycho-education and support.
    Knowing that you are not alone in your experiences, and that it isn’t “all in your head” or something you should be “thankful” for can go a long way in reducing stress and even symptoms. The support group psas-support is an important resource for anyone living with PGAD.
  2. Identifying triggers.
    For some women, certain triggers make the pain or discomfort worse. Discovering what the triggers are can make it easier to avoid them.
  3. Pelvic massage.
    Stretching and pelvic massage which can relax the pelvic floor muscles and increase awareness of stress and tension, may help in reducing pain. A physiotherapist or other healthcare practitioner with experience in pelvic issues may provide some help in this area.
  4. Medications.
    Given that some medications may be related to onset of PGAD for some women, it is understandable that they may not want to pursue treatment. On the other hand, the experience can be so distressing that some women will take a “whatever works” approach. No single medications are recommended, and Lieblum suggests that finding one that works is a process of trial and error to be done with your physician.

How Common is PGAD?

The original study that analyzed data from women included 103 women, and the survey developed by the researchers has now been filled out by over 400 women online (as of October 2006). While it is likely that the experience of persistent genital arousal is rare, given the lack of emphasis put on sexual health in our culture, it’s possible that the disorder is more common than researchers think it is.

Whether or not it is rare, the fact is that for women living with PGAD the symptoms can cause extreme distress and have a significant negative impact both on their sexuality and their entire lives. Hopefully researchers will continue to investigate this condition, and women will continue to speak up and not suffer in silence.

For more information on persistent genital arousal disorder visit the PSAS Support Group

Sources:

  1. 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.
  2. 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.
  3. Leiblum, S.R. “Persistent Genital Arousal Disorder: What It Is and What It Isn’t” Contemporary Sexuality.Vol. 40, No. 10 ( 2006): 8-13.
  4. 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.
  5. 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.
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