When you are sexually aroused, your body responds with physical changes. Those changes can last for hours and are usually triggered by something sexy. However, sometimes you feel the same feelings for no apparent reason. That’s a sign of persistent genital arousal disorder.
PGAD is rare and affects mostly women and people assigned female at birth. It has also been reported in men, but less often.
Symptoms
Persistent genital arousal disorder (PGAD) is unrelenting, unwanted, persistent, intrusive and spontaneous sensations of pressure/discomfort, engorgement, pulsating, throbbing and/or arousal in the clitoris, vulva, perineum and/or anus that are not precipitated by sexual desire and are not resolved by orgasm. Persistent genital arousal is often accompanied by distress and/or suicidal ideation. PGAD is also associated with vulvodynia, which describes a chronic unexplained pain in the vulva; and penoscrotodynia, which involves persistent painful irritation of nerves around the anus.
With other arousal disorders, you feel excited suddenly and easily triggered by certain things such as a bumpy car ride or sitting in a meeting at work. But with PGAD, your arousal is constant and involuntary, regardless of sexual thoughts or other stimulation. And if you orgasm, the feelings return quickly.
A 54-year-old man with PGAD told his doctor that for 2 years he had constant physical arousal in the genital area and a feeling that he needed to ejaculate for relief. He tried a variety of arousal techniques including masturbation and sexual activity. But the arousal and pain increased and he was left feeling anxious, tired and nauseated.
The researchers who identified PGAD in 2001 discarded the word “sexual” from its description because it implying desire, which doesn’t apply to this condition. PGAD is different from hypersexuality, which causes you to think about sex all the time and can’t control your behavior.
Diagnosis
When most people think of sexual arousal, they think of elation and pleasure. However, some people who have a psychological condition known as persistent genital arousal disorder (PGAD) experience sexually arousing sensations in the pelvic area without a corresponding increase in subjective desire or orgasm. PGAD is a distressing and largely unrecognized men’s health concern.
Often, a person with PGAD will masturbate to try to relieve the symptoms. But the resulting feelings of relief are short-lived, and only serve to intensify the symptoms. PGAD is also linked to stress and anxiety, which can further aggravate the symptoms.
Researchers don’t know for sure what causes PGAD, but a combination of factors likely plays a role. These include blood flow and nerves, as well as behavioral health issues like depression and anxiety. Symptoms can also be triggered or worsened by certain medications, such as SSRIs used to treat depression and anxiety.
The most effective treatment for PGAD revolves around identifying and managing the medical, physical, and emotional causes of the symptoms. A doctor will usually perform a physical exam to rule out medical causes, such as pelvic problems like varicose veins or a hernia. The doctor may also order tests to check hormone levels and look at brain activity. In some cases, the doctor will use a tampon-sized device to measure the amount of blood flow in the vagina.
Treatment
PGAD can have a significant negative impact on people’s quality of life. It can cause distress, physical pain and interfere with relationships. It can also be difficult to diagnose because the symptoms are often similar to what people feel when they’re sexually aroused, such as clitoral swelling or an erection. If you have PGAD, it’s important to understand that you’re not alone and that there are effective treatments available.
Treatments for PGAD vary depending on the underlying cause. If the symptom is caused by a medical issue, such as a thyroid disorder or ovarian cysts, a doctor who specializes in that condition will be able to help. If the underlying cause is psychological, you will need to talk to a psychotherapist or psychologist.
Your doctor may want to do some tests to check your hormone levels and the blood flow to your genital area before and after you’re aroused. They’ll likely use a special tampon-sized device to measure the amount of blood flowing through your vagina. They may also look for underlying conditions, such as Tourette’s syndrome, restless leg syndrome or epilepsy.
Getting help is especially important if you’re experiencing PGAD that disrupts your daily routine or causes distress. Your doctor will recommend a treatment plan that can include a combination of medications, therapy or other treatments that can help you cope with the symptom and live a normal life.
Prevention
Arousal in the genital area may be a sign of certain medical problems such as priapism, urinary tract infections and Peyronie’s disease. It is important to have these medical issues evaluated and treated, before focusing on psychological concerns.
The first step in treating PGAD is to talk to your family physician or an OBGYN. A thorough evaluation is necessary to rule out medical problems such as a stroke, sex abnormalities, depression and medication side effects.
Symptoms of PGAD can be triggered by sexual and non-sexual cues, or no cue at all. The arousal is unwanted and intrusive, causing distressing sensations of pressure/discomfort, engorgement, sensitivity or pulsating in the anus, perineum or genitalia. These symptoms are often unrelenting and do not disappear after achieving orgasm. PGAD is distinct from hypersexuality (also known as nymphomania), which is an involuntary desire to engage in frequent sexual activity.
Unlike normal sexual arousal, which feels good partly because you want to experience the physical sensations, PGAD doesn’t have a feeling of desire associated with it. This distinguishes it from impulsive arousal disorders, which are similar to PGAD in that you have trouble controlling the feelings. In contrast, impulsive arousal disorders are associated with negative thoughts and feelings, such as shame and self-loathing. You may also have difficulty sleeping due to arousal, which can further contribute to feelings of distress.
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