Persistent Genital Arousal Disorder (PGAD)

Persistent Genital Arousal Disorder (PGAD) – wait for it – the smirks from the male readers, followed by the comments, “Wish my wife, girlfriend and/or date had that.” Let’s describe the situation a little differently. Recall the regular reminders for the impotence drug commercials, “If you have an erection lasting four hours or more, seek immediate medical attention.” Why seek medical help? The condition is called Priaprism, an erection that doesn’t cease. It’s a painful malfunction that’s treated by a doctor sticking a long needle into the penis to redraw the blood. Hope not many a wife, girlfriend and/or date wish her partner had that experience. Persistent Sexual Arousal Syndrome (PSAS) renamed Persistent Genital Arousal Disorder (PGAD) can be as painful physically and mentally. It is compared to Priaprism in men. Some women describe it as a living hell.

Persistent Genital Arousal Disorder was first named by sex therapist Dr. Sandra Leiblum, PhD in 2001 as Persistent Sexual Arousal Syndrome. As Dr. Leiblum studied patients, she discovered the problem was more a disorder than a syndrome. The definition of a syndrome is a constellation of symptoms that suggest the presence of true disease.

Dr. Leiblum, who died this year, was Professor of Psychiatry and Obstetrics/Gynecology, Director of the Center for Sexual and Relational Health and Director of the Psychology Internship Program at UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ. In an article in the Journal of Sex & Marital Therapy, Leiblum and her co-authors identified a series of medical and psychological traits, including depression and panic attacks, which can accompany PGAD. While a number of women are helped by psychiatric drugs, Leiblum vigorously resisted the idea that the problem is necessarily psychological.

In one case study, a woman developed Persistent Genital Arousal Disorder during pregnancy. The Disorder returned some months after delivery. Her fears mounted over plans for a long family car trip, when a doctor prescribed the anti-anxiety medication Paxil. Soon after beginning medicating herself, she found the urges became less frequent. Nowadays, she can go up to 10 days without discomfort.

A British collaborator of Dr. Leiblum found that a number of women complaining of PGAD can have concomitant conditions like a yeast infection or a dermatological outbreak around the genitals. Leiblum insisted that the only thing for sure is that both can happen at the same time, not that one causes the other.

Another case reported a young woman in her 20’s who developed Persistent Genital Arousal Disorder prior to menses. She was required to find relief so often during the days prior that she could not hold a job. She spent too much time in the bathroom at work, and at home. She described the ordeal as a continuous state of arousal, with intense tingling and warmth in the vaginal area. The increased discharge soiled her outer clothes with embarrassing wet spots. The sensations were not accompanied by sexual fantasies.

Even an 81 year old woman with a hysterectomy was identified. The woman was married three time and living with her third husband enjoying an active sex life. She developed the Disorder after her hysterectomy. The woman went to several medical doctors including an internist, a reproductive endocrinologist who referred her for psychosexual evaluation when she was found physically healthy. She was every often awakened in the morning by hot flashes, which started recently, and with congestion in her pelvic area. Even though she was using low-dose estrogen, she reported that her vagina was dry and that she occasionally used estrogen cream or other lubricants.

The Disorder was identified in women of various ages, degrees of sexual activity, some with overactive bladders, and others with restless leg syndrome. The problem was identified in a woman after a car accident interviewed in this video. In April 2010, Fox News reported a British woman developed PGAD after falling off her Wii Fit board and damaging a nerve. Until a cause is pinpointed and treatment found, women may have to live with the sensations that can last hours or even days, and beyond any doubt are unwanted and invasive.

Leiblum SR, Nathan S. Persistent sexual arousal syndrome: a newly discovered pattern of female sexuality. J Sex Marital Ther. 2001;27(4):365-380.

Leiblum SR. Sexual problems and dysfunction: epidemiology, classification and risk factors. J Gend Specif Med. 1999;2(5):41-45.

Michael R, Gagnon J, Laumann E, Kolata G. Sex in America: Definitive Survey. Boston, Mass: Little, Brown and Company; 1994.

Utrecht University (2008, December 17). Persistent Imminent Orgasms In Women Are Associated With Restless Legs. ScienceDaily. Retrieved May 15, 2010, from http://www.sciencedaily.com­ /releases/2008/12/081216115010.htm

Waldinger et al. Persistent Genital Arousal Disorder in 18 Dutch Women: Part I. MRI, EEG, and Transvaginal Ultrasonography Investigations. Journal of Sexual Medicine, 2009; DOI: 10.1111/j.1743-6109.2008.01113.x

Waldinger et al. Persistent Genital Arousal Disorder in 18 Dutch Women: Part II-A Syndrome Clustered with Restless Legs and Overactive Bladder. Journal of Sexual Medicine, 2009; DOI: 10.1111/j.1743-6109.2008.01114.x