What if one had to live with a condition where carrying out even the most basic of tasks becomes a struggle due to persistent, unwanted and unrestrained sexual arousal, where there is no satisfaction or pleasure involved? Sadly, many women live with this condition called persistent genital arousal disorder (PGAD).
However, a new study sheds more light on this disabling condition and advocates for its treatment as a neurological disorder. "This report associates PGAD with disorders and lesions of the lower spinal cord, roots, and nerves that control sexual arousal and orgasm," according to the paper by Saurabh Sharma, MD.
What is persistent genital arousal disorder (PGAD)?
It is a condition, which mostly affects women of all ages, which is characterised by unwanted, spontaneous, uncontrollable and constant genital arousal. It remains unresolved post-orgasm and can be set off by sexual or nonsexual stimuli. Psychological problems, stress and physical pain caused by the disorder can limit one's ability in performing everyday functions. Unlike hypersexuality, where sexual desire is intense, PGAD is limited to unconstrained arousal.
For the research, 10 women, whose symptoms began between ages 11 to 70 years, were evaluated for PGAD. Majority of these women experienced daily episodes of sexual arousal which lasted anywhere between a few minutes to hours. A few of them experienced nearly continuous episodes lasting for days or even years. Resorting to masturbation to lessen the arousal, in spite of not being pleasurable, provided short-term relief.
The researchers found that psychiatric treatment for PGAD was ineffective. Supporting this argument was the case of the oldest patient, who had a history of many psychiatric hospitalizations and electroconvulsive therapy sessions. Also, ineffective were injections, medications, and nerve blocks, which worsened symptoms often.
When neurological evaluation was applied, it helped identify factors associated with PGAD and other possible causes. Additional information was acquired through neurological testing in several patients. These findings included nerve conduction abnormalities, sensory nerve disorders, and spinal nerve root lesions. Only one woman exhibited co-localizing somatosensory symptoms such as pain in the pelvis, buttocks, or leg.
Neurological evaluation led to effective neurological treatments in many cases. One patient experienced long-term relief from the gradually decreasing use of an antidepressant drug connected with the emergence of symptoms. The surgical removal of nerve cysts in the lower spine and pelvis region led to the curing of the condition. Another experienced relief from PGAD and other neurological symptoms when intravenous immune globulin was administered.
A step towards better understanding and treatment of PGAD
The question of how common or widespread PGAD is yet to see larger uncovering. However, clinically, it has been identified mostly in women, with only a few cases have been reported in men. Another important diagnostic challenge that the researchers highlight is that most of these cases are diagnosed by men. "Women's complaints of inappropriate arousal are typically attributed (by predominantly male evaluators) to psychopathology or misinterpreted as beneficial," they pointed out.
Advocating for PGAD to be treated as "a disorder of special sensation akin to neuropathic pain and itch", the study also proposes suggestions for neurological evaluation and treatment for patients struggling with the condition.
"Our findings will have clinical implications if confirmed, because most PGAD patients now linger medically undiagnosed and untreated," concluded Sharma.