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What Is Persistent Genital Arousal Disorder?

Medically Reviewed by Michael W. Smith, MD on May 17, 2021

In the bedroom, things happen in a certain order. You get sexually aroused because of what you feel, see, smell, touch, and hear. Your body responds with physical changes. You usually get mentally excited too.

But sometimes arousal can happen for no reason at all, just out of the blue. You may get excited and even have an orgasm when there’s nothing triggering the sexual feelings. These changes can be frustrating and long-lasting. This condition is called persistent genital arousal disorder.

What Is Persistent Genital Arousal Disorder?

Persistent general arousal disorder, or PGAD, is rare. You may also hear it called restless genital syndrome. It almost always affects women. Only a few cases have been reported in men.

With other arousal disorders you have trouble getting stimulated. With PGAD you’re excited suddenly and constantly. You can’t control your arousal. Even if you bring yourself to orgasm, the feelings return swiftly.

Persistent genital arousal disorder is different from hypersexuality, where you think about sex all the time or struggle to control your sexual behavior. With PGAD, you’re aroused even when you’re not thinking about sex.

Symptoms

Sexual arousal usually requires your senses to be engaged. You feel, hear, or see things that put you in the mood. But with PGAD, you become aroused even though there’s nothing triggering your desire.

Feelings of arousal include increased blood flow to the genital area, causing the clitoris to swell and the genital area to throb and pound. Vaginal secretions also increase. The feelings can last for hours, days, or even weeks.

Experiencing an orgasm can give some momentary relief, but the symptoms quickly return. The feelings can be so overwhelming it’s hard to even sit down or concentrate. You may also have pelvis, buttock, or leg pain.

Like any sexual issue, the condition can be upsetting. It can strain relationships. You may be too embarrassed to talk to your doctors about it. This can also lead to feelings of depression and anxiety.

Causes

Doctors are still working to learn all the possible causes of PGAD. It has been linked to:

  • Psychological concerns, including stress
  • Medication side effects, such as antidepressants
  • Genital infections
  • Pelvic issues
  • Hormonal changes, including stopping or starting hormone therapy after menopause

Recent research shows that nerves may play a role. In one study, several women with the condition had cysts (fluid-filled sacs) on their nerves near the base of their spine. Another had a spinal cord defect and another had a herniated disc.

Diagnosis

Your doctor will do a physical exam and a psychological evaluation. They’ll talk to you about your medical and sexual history and ask you about your symptoms.

You’ll usually have tests to check hormone levels in your blood. You’ll likely also get a special test that measures blood flow to your genitals before and after you’re aroused. One way your doctor might do this is with a tampon-sized device that uses light to measure the amount of blood circulating within your vaginal wall.

You may also get tests like an EEG, CT scan, or MRI to look for neurological issues that could be causing your symptoms. The doctor will check for conditions like epilepsy, Tourette’s syndrome, restless legs syndrome, or overactive bladder.

A PGAD diagnosis is based on arousal that:

  • Lasts for hours, days, or longer and doesn’t go away easily
  • Doesn’t end with orgasms
  • Is intrusive or unwanted
  • Isn’t triggered by sexual activity
  • Causes distress

Treatment

If your doctor can pinpoint a specific cause, they’ll treat it. For example, you might need to have a cyst removed or stop taking a medication that’s causing your symptoms. If they aren’t sure of the exact cause, they’ll focus on managing your symptoms.

Treatments can include:

  • Pelvic massage
  • Mindfulness-based cognitive therapy
  • Biofeedback
  • Anxiety treatment, including therapy and antidepressants
  • Topical numbing medications
  • Ice or ice baths
  • Acupressure
  • Pain medications
  • Muscle relaxants
  • TENS (transcutaneous electrical nerve stimulation) unit
  • Anti-seizure medications

Outlook

Doctors are working to learn more about understanding causes and treatments. Sometimes just being diagnosed and knowing that your condition has a name can help with stress and uncertainty. Working with your doctor is the first step toward symptom relief and finding a cause.

Show Sources

SOURCES:

American Sexual Health Association: “Sexual Arousal Disorder.”

Alvarado Hospital Medical Center: “Persistent Genital Arousal Disorder (PGAD).”

Pain Reports: “Persistent genital arousal disorder: a special sense neuropathy.”

Massachusetts General  Hospital: “Study reveals insights on hidden sexual-arousal disorder.”

Neuropathy Commons: “Persistent Genital Arousal Disorder, aka PGAD.”

Journal of Sex and Marital Therapy: “Persistent sexual arousal syndrome: a newly discovered pattern of female sexuality.”

Indian Journal of Psychological Medicine: “Persistent Genital Arousal Disorder.”

Boston University School of Medicine: “Persistent Sexual Arousal Syndrome.”

Mayo Clinic: “Female sexual dysfunction.”

Merck Manual: “Sexual Arousal Disorders,” “Persistent Genital Arousal Disorder.”

The Institute for Sexual Medicine: “Persistent Genitial Arousal Disorder in Women (PGAD).”

Fertility and Sterility: “Physiologic Measures of Sexual Function in Women: A Review.”

The Journal of Sexual Medicine: “Persistent Genital Arousal Disorder: Characterization, Etiology, and Management.”

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