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Persistent genital arousal disorder

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Persistent Genital Arousal Disorder (PGAD), originally called Persistent Sexual Arousal Syndrome (PSAS) and also known as Restless Genital Syndrome or Mempin Syndrome (ReGS or RGS)[1] [2], results in a spontaneous and persistent genital arousal, with or without orgasm or genital engorgement, unrelated to any feelings of sexual desire. It is not yet recognized as a diagnosable medical or psychiatric disorder by the DSM-IV. It was first documented by Dr. Sandra Leiblum in 2001,[3] only recently characterized as a distinct syndrome in medical literature.[4] Some physicians use the term Persistent Sexual Arousal Syndrome to refer to the condition in women; others consider the syndrome of priapism in men to be the same disorder.[4][5] In particular, it is not related to hypersexuality, sometimes known as nymphomania or satyriasis. In addition to being very rare, the condition is also frequently unreported by sufferers who may consider it shameful or embarrassing.[6]

Physical arousal caused by this syndrome can be very intense and persist for extended periods, days or weeks at a time. Orgasm can sometimes provide temporary relief, but within hours the symptoms return. The symptoms can be debilitating, preventing concentration on mundane tasks. Some situations, such as riding in an automobile or train, vibrations from mobile phones, and even going to the toilet can aggravate the syndrome unbearably.[7][8]

A Dutch study has connected PSAS with restless legs syndrome.[9]

Possible causes and treatment

There is not enough known about persistent genital arousal disorder to definitively pinpoint a cause. Medical professionals think it is caused by an irregularity in sensory nerves, and note that the disorder has a tendency to strike post-menopausal women in their 40s and 50s, or those who have undergone hormonal treatment. It can affect a person at any age. [10]

Some drugs such as trazodone may cause priaprism (which is recognized medical condition, unlike PGAD) as a side effect,[11] in which case discontinuing the medication may give relief. Additionally, the condition can sometimes start only after the discontinuation of SSRIs.[12] In some recorded cases, the syndrome was caused by a pelvic arterial-venous malformation with arterial branches to the penis or clitoris; surgical treatment was effective in this case.[5]

In other situations where the cause is unknown or less easily treatable, the symptoms can sometimes be reduced by the use of antidepressants, antiandrogenic agents and anaesthetising gels. Psychotherapy with cognitive reframing of the arousal as a healthy response may also be used.

More recently, the symptoms of the condition have also been linked with pudendal nerve entrapment. Regional nerve blocks and less common surgical intervention have demonstrated varying degrees of success in most cases.

In one recent case, serendipitous relief of symptoms was noted from treatment with varenicline, a treatment for nicotine addiction.[13][14]

See also

Footnotes

  1. ^ Restless Genital Syndrome
  2. ^ Persistent Sexual Arousal Syndrome Renamed As Restless Genital Syndrome
  3. ^ Leiblum, Sandra. "Persistent Sexual Arousal Syndrome in Women". Quadrant HealthCom Inc. Retrieved 2009-06-19. {{cite web}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  4. ^ a b Leiblum, S.R. & Nathan, S.G. (July 1, 2001). "Persistent Sexual Arousal Syndrome: A Newly Discovered Pattern of Female Sexuality". Journal of Sex & Marital Therapy. 27 (4): 365–380. doi:10.1080/009262301317081115.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ a b Goldstein, Irwin (3/1/2004). "Persistent Sexual Arousal Syndrome". Boston University Medical Center Institute for Sexual Medicine. Retrieved 2007-05-04. {{cite news}}: Check date values in: |date= (help); Cite has empty unknown parameter: |coauthors= (help)
  6. ^ Thompson, Michelle (2008-07-15). "PSAS Persistent Sexual Arousal Syndrome – One Big Climax". Multiple Sclerosis Alternatives. Retrieved 2009-06-20.
  7. ^ Leiblum, Sandra (1999). "Sexual problems and dysfunction: epidemiology, classification and risk factors". Gender Specific Medicine. 2 (5): 41–45.
  8. ^ Berczuk, Carol (2008-02-21). "Medical Mystery: Persistent Sexual Arousal Syndrome". ABC 20/20. p. 2. Retrieved 2009-06-20. {{cite news}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  9. ^ Waldinger (2008-12-17). "Persistent Imminent Orgasms in Women are Associated with Restless Legs". Science Daily. ScienceDaily LLC. Retrieved 2009-06-20.
  10. ^ "Injury turns 24 year old woman into a sex addict".
  11. ^ Finger, William W., Lund, Margaret and Slagel, Mark A. (Jan, 1997). "Medications that may contribute to sexual disorders: a guide to assessment and treatment in family practice". Journal of Family Practice. 44 (1): 33–43. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link)
  12. ^ Goldmeier D, Leiblum SR. Persistent genital arousal in women - a new syndrome entity Int J STD & AIDS 2006; 17:215-6. PMID 16595040.
  13. ^ Joanna B. Korda, MD; et al. (2009-02-18). "Persistent Genital Arousal Disorder: A Case Report in a Woman with Lifelong PGAD Where Serendipitous Administration of Varenicline Tartrate Resulted in Symptomatic Improvement". Journal of Sexual Medicine. pp. 1479–1486. {{cite web}}: Explicit use of et al. in: |author= (help)
  14. ^ The patient from the preceding study was featured in a televised documentary, "Strange Sex", aired on TLC 2010-01-27
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