(3 intermediate revisions by the same user not shown)
Line 1:
Line 1:
'''Persistent genital arousal disorder''' ('''PGAD'''), previously called '''persistent sexual arousal syndrome''',<ref name="Balon">{{cite book |authors=Richard Balon, Robert Taylor Segraves|title=Clinical Manual of Sexual Disorders|publisher=[[American Psychiatric Pub]]|isbn=978-1585629053|year=2009|page=193|accessdate=February 8, 2018|url=https://books.google.com/books?id=YuP3Hb0TMLQC&pg=PA193}}</ref> is spontaneous, persistent, unwanted and uncontrollable [[sexual arousal|genital arousal]] in the absence of [[sexual stimulation]] or [[sexual desire]],<ref name="Andriole">{{cite book |authors=Gerald L. Andriole|title=Year Book of Urology 2013, E-Book|publisher=[[Elsevier Health Sciences]]|isbn=978-1455773169|year=2013|page=160|accessdate=February 8, 2018|url=https://books.google.com/books?id=USLhAQAAQBAJ&pg=PT160}}</ref><ref name="Gordon">{{cite book |authors=David A. Gordon, Mark R. Katlic|title=Pelvic Floor Dysfunction and Pelvic Surgery in the Elderly: An Integrated Approach|publisher=[[Springer Publishing|Springer]]|isbn=978-1493965540|year=2017|page=259|accessdate=February 8, 2018|url=https://books.google.com/books?id=F4olDwAAQBAJ&pg=PA259}}</ref> and is typically not relieved by [[orgasm]].<ref name="Gordon"/><ref name="Sharpless">{{cite book |author=Brian A. Sharpless|title=Unusual and Rare Psychological Disorders: A Handbook for Clinical Practice and Research|publisher=[[Oxford University Press]]|isbn=978-0190245863|year=2016 |pages=110–120|accessdate=February 8, 2018|url=https://books.google.com/books?id=dgc1DQAAQBAJ&pg=PA110}}</ref> Instead, multiple orgasms over hours or days may be required for relief.<ref name="Sharpless"/>
PGAD occurs in women.<ref name="Sharpless"/><ref name="Wylie">{{cite book |author=Kevan R. Wylie|title=ABC of Sexual Health|publisher=[[John Wiley & Sons]] |isbn=978-1118665565|year=2015|page=52|accessdate=February 8, 2018|url=https://books.google.com/books?id=oH64CAAAQBAJ&pg=PA52}}</ref> It has been compared to [[priapism]] in men.<ref name="Wylie"/><ref name="Leiblum">{{cite book |author=Sandra R. Leiblum|title=Principles and Practice of Sex Therapy, Fourth Edition|publisher=[[Guilford Press]] |isbn=1606238272|year=2006|page=60|accessdate=October 14, 2019|url=https://books.google.com/books?id=IoG26ZJ-gkkC&pg=PA60}}</ref> PGAD is rare and is not well understood.<ref name="Andriole"/><ref name="Sharpless"/> The literature is inconsistent with the nomenclature. It is distinguished from [[hypersexuality]], which is characterized as heightened sexual desire.<ref name="Balon"/><ref name="Sharpless"/>
==Classification==
In 2003, "persistent genital arousal" was considered for inclusion with regard to the International Consultation on Sexual Medicine (ICSM). In 2009, "persistent genital arousal dysfunction" was included in its third edition.<ref name="Sharpless"/> PGAD is not included in the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' ([[DSM-5]]) or the [[International Classification of Diseases]] ([[ICD-10]]), which may be due to the disorder requiring further research.<ref name="Sharpless"/>
The condition has been characterized by a researcher as being a term with no scientific basis.<ref name=":0">{{Cite journal|last=Komisaruk|first=Barry R.|date=April 2015|title=Re: Puppo V, Puppo G. 2014. anatomy of sex: Revision of the new anatomical terms used for the clitoris and the female orgasm by sexologists|journal=Clinical Anatomy (New York, N.Y.)|volume=28|issue=3|pages=290|doi=10.1002/ca.22488|issn=1098-2353|pmid=25511419}}</ref> There is concern that the title may be misleading because, since the genital arousal is unwanted, it is dubious to characterize it as arousal.<ref name=":0" />
Other researchers have suggested that the disorder be renamed "persistent genital [[vasocongestion]] disorder (PGVD)"<ref name="Padoa"/> or "restless genital syndrome (ReGS)."<ref name="Padoa"/><ref name="Stetka">{{cite web|last1=Stetka|first=Bret S.|last2=De Aquino|first2=Camila Henriques|title=What Is Restless Genital Syndrome?|date=March 3, 2015|accessdate=February 8, 2018|work=[[Medscape]]|url=https://www.medscape.com/viewarticle/840692}}</ref>
==Signs and symptoms==
Physical arousal caused by PGAD can be very intense and persist for extended periods, days or weeks at a time.<ref name="Gordon"/><ref name="Sharpless"/> Symptoms include pressure, pain, irritation, [[clitoral]] tingling, throbbing, vaginal congestion, vaginal contractions, and sometimes spontaneous orgasms.<ref name="Gordon"/> Pressure, discomfort, pounding, pulsating, throbbing or engorgement may include the clitoris, [[labia]], [[vagina]], [[perineum]], or the [[Human anus|anus]].<ref name="Wylie2">{{cite book |author=Kevan R. Wylie|title=ABC of Sexual Health|publisher=[[John Wiley & Sons]]|isbn=978-1118665565|year=2015|page=39|accessdate=February 8, 2018|url=https://books.google.com/books?id=FdOfBwAAQBAJ&pg=PA39}}</ref> The symptoms may result from sexual activity or from no identified stimulus, and are not relieved by orgasm except for cases where multiple orgasms over hours or days allow for relief.<ref name="Sharpless"/> The symptoms can impede on home or work life.<ref name="Gordon"/><ref name="Padoa">{{cite book |authors=Anna Padoa, Talli Y. Rosenbaum|title=The Overactive Pelvic Floor|publisher=[[Springer Publishing|Springer]]|isbn=978-3319221502|year=2009|page=25|accessdate=February 8, 2018|url=https://books.google.com/books?id=d2giCwAAQBAJ&pg=PA25}}</ref> Women may feel embarrassment or shame, and avoid sexual relationships, because of the disorder.<ref name="Gordon"/><ref name="Sharpless"/> Stress can make the symptoms worse.<ref name="Padoa"/><ref name="Wylie2"/>
==Cause==
Researchers do not know the cause of PGAD, but assume that it has [[neurological]], [[vascular]], [[pharmacological]], and [[psychological]] causes.<ref name="Balon"/><ref name="Sharpless"/> [[Tarlov cyst]]s have been speculated as a cause.<ref name="Gordon"/><ref name="Wylie2"/> PGAD has been associated with [[Priapism#Classification|clitoral priapism]],<ref name="Carcio">{{cite book |authors=Helen Carcio, MS, MEd, ANP-BC, R. Mimi Secor, MS, MEd, FNP-BC, NCMP, FAANP|title=Advanced Health Assessment of Women, Third Edition: Clinical Skills and Procedures|publisher=[[Springer Publishing Company]]|isbn=978-0826123091|year=2014|page=85|accessdate=February 8, 2018|url=https://books.google.com/books?id=Q4QbBQAAQBAJ&pg=PA85}}</ref> and has been compared to priapism in men.<ref name="Wylie"/><ref name="Leiblum"/> It is also similar to [[vulvodynia]], in that the causes for both are not well understood, both last for a long time, and women with either condition may be told that it is psychological rather than physical.<ref name="Gordon"/> It has been additionally associated with [[restless legs syndrome]] (RLS), but a minority of women with PGAD have restless legs syndrome.<ref name="Padoa"/>
In some recorded cases, the syndrome was caused by or can cause a pelvic arterial-venous malformation with arterial branches to the clitoris.<ref name="Wylie2"/><ref name="Boston">{{cite news | first=Irwin | last=Goldstein | title=Persistent Sexual Arousal Syndrome | date=1 March 2004 | publisher=[[Boston University Medical Campus]] Institute for Sexual Medicine | url =http://www.bumc.bu.edu/sexualmedicine/informationsessions/persistent-sexual-arousal-syndrome/ | work = | pages = | accessdate = 2007-05-04 | language = }}</ref> Surgical treatment was effective in this instance.<ref name="Boston"/>
{{Infobox medical condition
| name = Persistent genital arousal disorder
| synonyms = PGAD, Restless genital syndrome
| field = [[Gynecology]], [[Urology]], [[Sexual medicine]]
| symptoms = [[Genital arousal]] without sexual desire, [[Spontaneous orgasm]]
'''Persistent Genital Arousal Disorder''' ('''PGAD'''), also known as '''Restless Genital Syndrome''', is a condition characterized by unwanted and persistent genital arousal in the absence of sexual desire. This condition can cause significant distress and impact the quality of life of those affected.
==Signs and Symptoms==
Individuals with PGAD experience spontaneous, intrusive, and unwanted genital arousal, which may include sensations such as tingling, throbbing, or engorgement. These symptoms can occur without any sexual stimulation or desire and may persist for extended periods. The arousal is often unrelieved by orgasm, which can lead to frustration and distress.
==Causes==
The exact cause of PGAD is not well understood. Several potential factors have been proposed, including:
* [[Neurological]] factors: Abnormalities in the sensory nerves or central nervous system may contribute to the condition.
* [[Vascular]] factors: Increased blood flow or vascular congestion in the genital area might play a role.
* [[Hormonal]] imbalances: Changes in hormone levels could potentially influence symptoms.
* [[Psychological]] factors: Stress, anxiety, or other psychological conditions may exacerbate symptoms.
==Diagnosis==
Diagnosis of PGAD is primarily clinical, based on the patient's history and symptoms. A thorough evaluation is necessary to rule out other conditions that may mimic PGAD, such as [[urinary tract infections]], [[vulvodynia]], or [[pelvic floor dysfunction]].
==Treatment==
==Treatment==
Because PGAD has only been researched since 2001, there is little documenting what may cure or remedy the disorder.<ref name="Sharpless"/> Treatment may include extensive [[psychotherapy]], psycho-education, and pelvic floor physical therapy.<ref name="Sharpless"/><ref name="Padoa"/> In one case, serendipitous relief of symptoms was concluded from treatment with [[varenicline]], a treatment for [[nicotine]] addiction.<ref name="Sharpless"/>
Treatment for PGAD is often challenging and may require a multidisciplinary approach. Options include:
* [[Medications]]: Antidepressants, anticonvulsants, or topical anesthetics may be used to alleviate symptoms.
== Epidemiology==
* [[Psychotherapy]]: Cognitive-behavioral therapy (CBT) or other forms of counseling can help manage the psychological impact of the disorder.
PGAD is very rare. Although online surveys have indicated that hundreds of women may have PGAD,<ref name="Sharpless"/> documented case studies have been limited to about 22.<ref>{{Cite journal | doi=10.1080/009262301317081115| pmid=11441520|title = Persistent Sexual Arousal Syndrome: A Newly Discovered Pattern of Female Sexuality| journal=Journal of Sex & Marital Therapy| volume=27| issue=4| pages=365–380|year = 2001|last1 = r. Leiblum|first1 = Sharon g. Nathan| last2=Nathan| first2=S. G.}}</ref><ref name="SL">{{cite journal|last=Leiblum|first=Sandra|date=September–October 1999|title=Sexual problems and dysfunction: epidemiology, classification and risk factors|journal=Journal of Gender-Specific Medicine|volume=2|issue=5|pages=41–45}}</ref><ref>{{Cite journal|last=Markos|first=A. R.|last2=Dinsmore|first2=Wallace|date=November 2013|title=Persistent genital arousal and restless genitalia: sexual dysfunction or subtype of vulvodynia?|journal=International Journal of STD & AIDS|volume=24|issue=11|pages=852–858|doi=10.1177/0956462413489276|issn=1758-1052|pmid=23970620}}</ref> No population data on the disorder exists.<ref name="Sharpless"/>
* [[Lifestyle modifications]]: Stress reduction techniques, pelvic floor exercises, and avoiding known triggers may be beneficial.
==Prognosis==
==History==
The prognosis for PGAD varies. Some individuals may experience relief with treatment, while others may have persistent symptoms. Ongoing research is needed to better understand and manage this condition.
The earliest references to PGAD may be Greek descriptions of [[hypersexuality]] (previously known as "satyriasis" and "nymphomania"), which confused persistent genital arousal with sexual insatiability.<ref name="Sharpless"/> While PGAD involves the absence of sexual desire, hypersexuality is characterized as heightened sexual desire.<ref name="Balon"/><ref name="Sharpless"/>
==Epidemiology==
PGAD is considered a rare condition, with most cases reported in women. However, it can occur in individuals of any gender and age.
The term ''persistent sexual arousal syndrome'' was coined by researchers Leiblum and Nathan in 2001.<ref name="Balon"/><ref name="Gordon"/> In 2006, Leiblum renamed the condition to "persistent genital arousal disorder" to indicate that genital arousal sensations are different from those that result from true sexual arousal.<ref name="Balon"/> The rename was also considered to give the condition a better chance of being classified as a dysfunction.<ref name="Balon"/>
==Research Directions==
Current research is focused on understanding the underlying mechanisms of PGAD and developing more effective treatments. Studies are exploring the role of the nervous system, hormonal influences, and potential genetic factors.
==See also==
==See Also==
{{Portal|Human sexuality}}
* [[Sexual dysfunction]]
* [[Vaginismus]]
* [[Vulvodynia]]
* [[Pelvic floor dysfunction]]
==References==
==External Links==
{{reflist|2}}
* [https://www.isswsh.org/ International Society for the Study of Women's Sexual Health]
* [https://www.nva.org/ National Vulvodynia Association]
==External links==
{{stub}}
* [http://www.psas.nl/ PSAS], information about PSAS in Dutch and English
{{Medical conditions}}
* [http://documentaryvine.com/video/hundred-orgasms-day/''A Hundred Orgasms A Day''], [[Channel 5 (UK)]] 2004 documentary film about PSAS
[[Category:Gynecology]]
* [https://web.archive.org/web/20100118124316/http://news.ninemsn.com.au/health/984359/car-crash-leaves-woman-constantly-aroused/ Car crash leaves woman constantly aroused], [[Ninemsn]], 16 December 2009
[[Category:Urology]]
[[Category:Psychiatry]]
{{Female diseases of the pelvis and genitals}}
{{Female diseases of the pelvis and genitals}}
{{stub}}
{{adapted}}
[[Category:Noninflammatory disorders of female genital tract]]
[[Category:Noninflammatory disorders of female genital tract]]
Persistent Genital Arousal Disorder (PGAD), also known as Restless Genital Syndrome, is a condition characterized by unwanted and persistent genital arousal in the absence of sexual desire. This condition can cause significant distress and impact the quality of life of those affected.
Individuals with PGAD experience spontaneous, intrusive, and unwanted genital arousal, which may include sensations such as tingling, throbbing, or engorgement. These symptoms can occur without any sexual stimulation or desire and may persist for extended periods. The arousal is often unrelieved by orgasm, which can lead to frustration and distress.
Diagnosis of PGAD is primarily clinical, based on the patient's history and symptoms. A thorough evaluation is necessary to rule out other conditions that may mimic PGAD, such as urinary tract infections, vulvodynia, or pelvic floor dysfunction.
The prognosis for PGAD varies. Some individuals may experience relief with treatment, while others may have persistent symptoms. Ongoing research is needed to better understand and manage this condition.
Current research is focused on understanding the underlying mechanisms of PGAD and developing more effective treatments. Studies are exploring the role of the nervous system, hormonal influences, and potential genetic factors.
