What is Persistent Genital Arousal Disorder (PGAD)?

By Pelvic Health Physical Therapy on 2/2/2024

Persistent genital arousal disorder (PGAD) is an extremely rare condition, affecting 1% of women and people assigned female at birth (AFAB).  Patients who have PGAD experience unpredictable, uncontrollable physical sensations associated with sexual arousal but in the absence of desire, and without relief after orgasm.  Although PGAD has mostly been studied in women and people AFAB, it may also affect men and people assigned male at birth.    

Instead of feelings of pleasure and relief with orgasm, PGAD often leads to feelings of frustration, embarrassment, and confusion.  Oftentimes, patients who experience these symptoms are too embarrassed to seek treatment.  If they do seek treatment, they tend to get referred to multiple healthcare providers due obscurity of the disorder.  In many cases, their symptoms get confused with hypersexuality disorder and they are told to have a glass of wine to deal with it. 

PGAD has only been identified in 2001 by Leiblum and Nathan.  Originally, PGAD was called persistent sexual arousal syndrome (PSAS).  The word “genital” replaced “sexual” because sexual implies desire, which doesn’t apply to PGAD.  This is an important difference between PGAD and hypersexuality, or sex addiction. Because of the recent identification and distinction between the two conditions, a quick Google search will bring up limited articles and information on the treatments, origins, and causes of PGAD.

The sensations of PGAD may take a toll on the body and can interfere with day-to-day routines, causing anxiety and depression. It may even be debilitating without help from a healthcare provider. Some of these symptoms may last for hours or even days and include:

• Pain or discomfort in the genitals;

• Genital fullness, swelling, and increased sensitivity; 

• Tingling in the clitoris;

• Vaginal contractions;

• Vaginal lubrication;

• Unpredictable orgasms;

• Persistent arousal triggered by stimuli, nonsexual stimuli, or no stimuli.

However, there is hope for those who suffer from PGAD.  Recent studies have demonstrated with appropriate intervention, patients may achieve improvement of their physical symptoms and a decrease in associated psychological distress.  The studies have suggested that a multidisciplinary treatment approach is most optimal, meaning having a team of doctors that understand the condition will increase a patient’s chance of getting their life back.  Pelvic floor physical therapy has been listed as an important part of the team, as their high-level knowledge of anatomy and physiology and their manual therapy skills will be able to detect tight muscles and trigger points that may be causing the patient’s distress.  Other factors that a pelvic floor physical therapist may treat would include:

• Improving joint mobility;

• Stretching affected muscles;

• Perform various modalities including shockwave, biofeedback, electrical stimulation, ultrasound;

• Performing myofascial release of affected tissues;

• Performing nerve releases;

• And many more!

PGAD is an uncommon and highly distressing condition that requires thoughtful evaluation for appropriate diagnosis and treatment.  If this sounds like you, and if you’ve been recently diagnosed with Persistent Genital Arousal Disorder, please reach out to Pelvic Health Center in Madison, NJ and schedule your initial visit today.  Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.

Also, please know that support is out there. Please see the link to the PGAD Discussions and Peer Support group and know that you are not alone: https://www.facebook.com/groups/1195423387216256 

Works Cited:

• https://www.sciencedirect.com/science/article/abs/pii/S2050052121000408#preview-section-abstract

• https://my.clevelandclinic.org/health/diseases/23998-persistent-genital-arousal-disorder 

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