PGAD: Overview

Content Written By: Irwin Goldstein, MD

Persistent genital arousal disorder (PGAD) is an uncommonly reported women’s sexual health concern. This was first reported in peer review medical literature by Leiblum and Nathan in 2001 and was initially called Persistent Sexual Arousal Syndrome (PSAS). The name was changed because patients complained that this condition was not about traditional sexual arousal.

Persistent genital arousal disorder (PGAD) is associated with unrelenting, unwanted, persistent, intrusive, and spontaneous sensations such as pressure/discomfort, engorgement, pulsating, pounding and/or throbbing in the genital tissues such as the clitoris, labia, vagina and/or in the perineum and/or anus in the absence of conscious thoughts of sexual desire or sexual interest. Persistent genital arousal disorder is often associated with significant personal bother and distress. Women with PGAD are often
ashamed for having inappropriate genital feelings. Women with PGAD are often having suicidal thoughts.

Persistent genital arousal disorder may be classified into primary, lifelong if the PGAD is present throughout the person's life or into secondary, acquired if the PGAD develops variably in later life. Persistent genital arousal disorder is associated with spontaneous orgasms or feelings that orgasm is imminent or feelings that orgasmic release is needed to reduce the feelings of persistent arousal, but where symptoms are not consistently diminished by orgasmic release.

In 2009, the combination of PGAD with Restless Legs Syndrome (RLS) and/or Overactive Bladder Syndrome (OAB) and/or Urethra Hypersensitivity has been called Restless Genital Syndrome (ReGS) by Waldinger et al

The unwanted genital sensations of Restless Genital Syndrome are typical dysesthesias or unpleasant sensations, such as burning, wetness, itching, pressure, or pins and needles, that may be, or not be, considered as a kind of pain and are often felt as an imminent orgasm in the absence of sexual desire or fantasies.

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