Contributed by: Abshar Faheem


Understanding Persistent Genital Arousal Disorder

Persistent genital arousal disorder, formerly known as persistent sexual arousal syndrome, is referred to as a spontaneous, uncontrollable, unwanted, and persistent genital arousal without any sexual stimulation or desire. It cannot be relieved with a single orgasm however, it requires multiple orgasms over hours or days to get relief. It is a rare condition that generally occurs in women regardless of age and is not well understood. 

People with persistent genital arousal disorder or PGAD are unable to carry out everyday tasks causing physical pain, stress, and other psychological issues. Doctors are not sure about the incidences associated with PGAD because many people feel shame and embarrassment to address this condition with their healthcare provider. As there is no reason for feeling sexually aroused, you may get all the symptoms of PGAD including swelling of the vagina and erection of the penis in men. PGAD includes the constant feeling of having an orgasm lasting over hours, days, or weeks. Therefore, it can disturb your daily activities.


Symptoms of Persistent Genital Arousal Disorder

The initial symptoms of PGAD may be a series of continuous and annoying sensations in different genital areas including swelling of the clitoris, anus, perineum, labia, and vagina, vaginal lips as well as other parts of the such as nipples. In men, it can cause pain in their penis or erections lasting over hours. These sensations are called dysesthesias that include


  • Pins and needles
  • Itching
  • Pressure
  • Burning
  • Pounding
  • Wetness
  • Red or flushed face and neck
  • Abnormal high blood pressure
  • Abnormal high heart rate
  • Rapid breathing
  • Blurred vision
  • Pain in the genital areas
  • Muscle spasm throughout the body


These symptoms of PGAD may happen in the absence of sexual desire. Climaxing may help you to get rid of the symptoms of PGAD however, it is a temporary solution because, after a few hours, those symptoms may come back. The events of intense arousal can occur frequently impacting daily routine and causing persistent discomfort. This may also lead to various psychological symptoms including 


People having incurable PGAD may also drop their thoughts of sexual pleasure as the orgasm becomes connected with the relaxation of pain rather than an enjoyable experience.


Causes of Persistent Genital Arousal Disorder

PGAD can have lots of causes, however, a particular cause is quite hard to diagnose. People with PGAD believe that sexual stimulation, masturbation, anxiety, and stress may trigger this condition. However, the exact cause behind the PGAD is unknown making people unable to identify triggers to avoid them. PGAD can occur in some women who have stress. Once the stress is relieved, the PGAD condition may calm down. 

Therefore, it is believed that PGAD can be psychological too. Some cases of PGAD usually occur alongside instances of mental health issues. Anxiety, depression, bipolar I disorder, OCD, and other related conditions have been recognized in cases of PGAD in both men and women. It is not yet clear if these conditions cause PGAD, but it is common for them to present alongside PGAD.

However, it is not always psychological, Sometimes medication may also cause PGAD. As per research, there is a link between PGAD and the hormones, nervous system, veins, and chemical balance after consuming certain sorts of drugs. 

Pressing a nerve called the pudendal nerve that helps you feel sensations around your genitals, is believed to cause PGAD. In rare cases, having priapism in your clitoris, which happens when your clitoris stays erect for long periods, may also cause PGAD. In men, abnormal blood flow in and out of the penis can cause priapism.

A woman got PGAD after brain surgery to address issues with her brain’s blood vessels. Some women got PGAD because of a stroke after discontinuing estrogen or cholesterol therapy. Other women seem to get PGAD because they discontinued taking an SSRI for depression. 

Experts believe that Tarlov cysts may also cause PGAD. Tarlov cysts are pouches stuffed with spinal fluid that develop on the sacral nerve root. Sacral nerves at the bottom of the spine get electrical signals from the brain, and they send these instructions to the bladder, colon, and genitals. 

As per research, some women with PGAD symptoms may also have a Tarlov cyst.  However, this does not hold for all cases but, in some cases, PGAD can be counted as a reaction to a Tarlov cyst. Experts believe that getting PGAD can be a secondary symptom of a few conditions including Tourette’s syndrome, trauma to the central nervous system, epilepsy, etc. 

Researchers are still trying to find out the exact cause behind PGAD as it becomes difficult to diagnose and treat the condition.


Diagnosis & Treatment of Persistent Genital Arousal Disorder

If you feel the symptoms of PGAD, talk with your healthcare provider. Your healthcare provider may do several things to determine whether these symptoms occur due to PGAD or any other underlying condition. It may include 


  • Physical examination of your genital areas
  • Checking of medications you consume and other conditions you may have
  • Psychologist 
  • Some tests to monitor blood flow in your genital areas before, during, and after sexual arousal
  • Neurological testing to check if nerve damage causing this condition


One or more tests can help your doctor to determine whether these symptoms are a result of PGAD’s condition. 

The treatment of PGAD includes managing the symptoms as it is yet unclear the exact cause of PGAD. The treatment includes psychological treatment such as counseling or cognitive-behavioral therapy (CBT) as this therapy can be helpful to manage stress, anxiety, and depression because these psychological issues often worsen the PGAD. 

Other treatments you can try include application of ice to the pelvic area, ECT or small electrical charges, changes in the medication, antidepressants, anti-seizure medications, masturbation( temporary), numbing gels, electroconvulsive therapy ( in case of mental disorder), and transcutaneous electrical nerve stimulation (TENS).


The bottom line

Persistent genital arousal disorder can interfere with your daily routine and impact the quality of your life. If you have symptoms of this condition, talk to your doctor immediately.


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