What are the other Names for this Condition? (Also known as/Synonyms)

• PGAD (Persistent Genital Arousal Disorder)

What is Persistent Genital Arousal Disorder? (Definition/Background Information)

• Persistent Genital Arousal Disorder (PGAD) in men may be considered as the condition of priapism and unwanted ejaculatory fluids being released without any sexual interest
• In women there is still no consensus about a formal definition, but some of the experts propose that in women it should be defined as a rare, unwanted, and intrusive sexual dysfunction associated with excessive and unremitting genital arousal and engorgement in the absence of sexual interest
• The persistent genital arousal usually does not resolve with orgasm and causes personal distress. Features include excessive excitement or excessive genital (lubrication, swelling, and engorgement) or other somatic responses
• Causes may be neurological (central or peripheral involving the pudendal nerve), related to medication, vascular, hormonal, psychological or others
• Diagnosis of the cause is essential for an adequate patient management. The treatment may include avoiding offending medications, using medications that stabilize nerve transmission and/or effect mood, local topical anesthetic agents, ice and hormonal replacement
• More recently Persistent Genital Arousal Disorder has being described as one component of a broader restless genital syndrome, if the PGAD was also associated with urinary frequency/urgency and restless leg syndrome

(Source: Persistent Genital Arousal Disorder; Genetic and Rare Disease Information Center (GARD) of National Center for Advancing Translational Science (NCATS), USA.)

Who gets Persistent Genital Arousal Disorder? (Age and Sex Distribution)

• Persistent Genital Arousal Disorder is a rare disorder, first described in 2001
• The disorder is more common in females, although men may be affected as well 
• Worldwide, individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Persistent Genital Arousal Disorder? (Predisposing Factors)

The risk factors for Persistent Genital Arousal Disorder may include:

• Increased intake of soy products
• Sacral spinal cysts (Tarlov cysts)
• Nerve injuries
• Restless leg syndrome
• Psychological disorders such as anxiety, panic, and depression
• Being on medications for psychological disorders (such as anti-depressants)
• Hyper-sensitivity to small changes in physical sensations 
• Onset of menopause
• Overactive bladder
• Physical inactivity

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Persistent Genital Arousal Disorder? (Etiology)

The exact cause of Persistent Genital Arousal Disorder is not clearly known at the present time. However, the following are reported to have a correlation with the condition:

• Onset of menopause and hormonal changes in women
• Stress
• Being on anti-depressants or mood stabilizers
• Presence of Tarlov cysts
• Restless leg syndrome
• Injury to, or abnormalities in, the central nervous system 
• Pelvic nerve hyper-sensitivity or entrapment
• Pelvic congestion
• Mechanical pressure against the genitals
• Overactive bladder
• Hyper-vigilance to even small changes in physical sensations

What are the Signs and Symptoms of Persistent Genital Arousal Disorder?

The signs and symptoms of Persistent Genital Arousal Disorder may include:

• Unwanted and involantary sexual arousal (with no sexual thoughts or desires)
• Excessive lubrication, swelling and engorgment (in women)
• Unwanted ejaculation in men
• Fatigue

How is Persistent Genital Arousal Disorder Diagnosed?

Persistent Genital Arousal Disorder is diagnosed on the basis of the following information:

• Complete physical examination
• Thorough medical history evaluation
• Assessment of signs and symptoms
• Laboratory tests
• Imaging studies
• Biopsy studies, if necessary
• Rule-out other factors and medical conditions that may be causing PGAD

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

The following criteria may be considered for an individual to be diagnosed with Persistent Genital Arousal Syndrome:

• Prolonged sexual arousal 
• Involantary sexual arousal (without sexual thought or desires)
• Non-resolution of arousal with sexual activity and orgasm
• Arousal being triggered by non-sexual stimulii
• The arousal leading to significant psychological distress

What are the possible Complications of Persistent Genital Arousal Disorder?

The complications of Persistent Genital Arousal Disorder may include:

• Embarassment
• Emotional distress and stress
• Severe depression that may lead to suicidal thoughts

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Persistent Genital Arousal Disorder Treated?

The treatment for Persistent Genital Arousal Disorder is generally tailored toward management of symptoms, and may include:

• Assessment and treatment of any underlying condition that may be causing PGAD
• Medications such as anti-depressants to relieve stress and distress
• Electroconvusive therapy
• Educating the affected individual to
  • Understand the condition
  • Identify triggers
  • Employ distracting techniques
• Pelvic massage to reduce pelvic floor tension

How can Persistent Genital Arousal Disorder be Prevented?

• Persistent Genital Arousal Disorder may be prevented by considering the following:
  • Identifying triggers and engaging in distraction techniques
  • Seeking medical attention promptly for conditions that may cause PGAD
• Active research is currently being performed to explore the possibilities for treatment and prevention of disorders such as Peristent Genital Arousal Disorder

What is the Prognosis of Persistent Genital Arousal Disorder? (Outcomes/Resolutions)

• The prognosis of Persistent Genital Arousal Disorder is dependent upon the severity of the signs and symptoms and associated complications, if any
• Individuals with mild conditions have better prognosis than those with severe symptoms and complications
• Typically, the prognosis may be assessed on a case-by-case basis

Additional and Relevant Useful Information for Persistent Genital Arousal Disorder:

• Persistent Genital Arousal Disorder was previously known as “peristent sexual arousal syndrome”

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/rare-disorders/