Persistent genital arousal disorder (PGAD)
Persistent genital arousal disorder (PGAD) is also called persistent sexual arousal syndrome (PSAS). People with this condition become sexually aroused without any sexual activity or stimulation. Even when there’s no reason to feel sexually aroused, you may feel all the symptoms of sexual arousal, such as an erection or swelling of the vagina. With PGAD, you may feel like you’re having orgasms constantly. In some cases, PGAD can last for hours, days, or weeks at a time. And it can be disruptive to your daily life.
PGAD is most commonly reported in women. It has also been reported in men. When men have this condition, it’s often called priapism. Priapism occurs when you have an erection lasting several hours or more even without anything sexually arousing causing the erection.
PGAD is treated based on what appears to be causing the persistent arousal.
In some cases, masturbation to orgasm may reduce some of the symptoms of arousal. But this method doesn’t always provide long-term relief. It may only provide temporary relief before symptoms return. In some cases, frequent masturbation to relieve PGAD may make symptoms worse or last longer.
Some other common treatments for PGAD include:
- numbing gels
- electroconvulsive therapy, which is used if a mental disorder such as bipolar I or severe anxiety is linked to the condition
- transcutaneous electrical nerve stimulation (TENS), which uses electrical currents to help relieve nerve pain
- clomipramine, an antidepressant often used to treat obsessive-compulsive disorder (OCD)
- fluoxetine, a selective serotonin reuptake inhibitor (SSRI) usually prescribed to treat major depressive disorder, panic disorder, and bulimia
- lignocaine (also called lidocaine) gel, which numbs the areas on your body it’s applied to
Some psychological methods, such as therapy or counseling, may help relieve symptoms. This may help if a condition like anxiety or depression is causing your symptoms or making them worse. These methods may be especially helpful if are experiencing feelings of guilt or shame about issues in your relationships or personal life.
Cognitive behavioral therapy (CBT) can also help. CBT will help you to learn to articulate and control your negative emotions and reactions. It can often help you address situations that may exacerbate the symptoms of PGAD.
Talking to a therapist might help you discover emotional triggers that could be causing PGAD. Meditation can also help reduce symptoms by reducing your anxiety and relaxing your muscles.
The most noticeable symptom of PGAD is a feeling of sexual arousal without any sexual stimulation. In women, this may cause feelings of arousal in the genital area, including the swelling of your clitoris, vagina, and vaginal lips, as well as other parts of your body, including your nipples. In men, this may cause general pain in your penis or erections that last several hours.
Other common symptoms of PGAD include:
- face and neck becoming red or flushed
- abnormally high blood pressure
- abnormally high heart rate
- shallow, rapid breathing
- muscle spasms throughout the body
- blurred or spotty vision
- pain in your genital area, especially the clitoris or penis shaft
PGAD can have a number of causes, but a specific cause is often hard to diagnose.
Pinching or compressing a nerve called the pudendal nerve, which helps you feel sensations around your genitals, is thought to cause PGAD. In rare cases, having priapism in your clitoris, which happens when your clitoris stays engorged or erect for long periods of time, may also cause PGAD. In men, improper blood flow in and out of the penis can cause priapism.
Some cases of PGAD often happen alongside cases of mental health issues. Anxiety, depression, bipolar I disorder, OCD, and other similar conditions have been identified in cases of PGAD in both men and women. It’s not clear if these conditions cause PGAD, but it’s common for them to exist alongside PGAD.
In one case, a woman developed PGAD after having brain surgery to address issues with her brain’s blood vessels. Some women develop PGAD because of a stroke after stopping estrogen or cholesterol therapy. Other women appear to develop PGAD because they stopped taking an SSRI for depression.
In men, PGAD may develop because of complications from vasectomy procedures or urinary tract infections.
If you believe you have PGAD, talk with your doctor about your symptoms. To make sure that your symptoms are a result of PGAD and not another condition, your doctor may want you to do the following:
- See a therapist or psychologist for a psychological assessment and testing.
- Get a full physical examination and a full assessment of how long you’ve had PGAD, what medications you’re taking, and any other conditions you may have.
- Get a physical examination of your genital area.
- Get tests measuring the blood flow to your genitals before, during, and after sexual arousal.
- Get neurological testing to see if nerve damage may be causing the condition.
One or more of these tests can help your doctor conclude if your symptoms result from PGAD.