Persistent sexual arousal syndrome
Encyclopedia
Persistent Genital Arousal Disorder (PGAD), originally called Persistent Sexual Arousal Syndrome (PSAS) and also known as Restless Genital Syndrome or Mempin Syndrome (ReGS or RGS), results in a spontaneous, persistent, and uncontrollable genital arousal
, with or without orgasm
or genital engorgement, unrelated to any feelings of sexual desire. It was first documented by Dr. Sandra Leiblum
in 2001, only recently characterized as a distinct syndrome
in medical literature with a comparable counterpart increasingly reported by men. Some physicians use the term Persistent Sexual Arousal Syndrome to refer to the condition in women; others consider the syndrome of priapism
in men to be the same disorder. Priapism is a recognized diagnosable medical condition by the DSM-IV, whereas PGAD is not. In particular, it is not related to hypersexuality
, sometimes known as nymphomania or satyriasis. Hypersexuality, nymphomania and satyriasis are also not recognized diagnosable medical conditions by the DSM-IV. In addition to being very rare, the condition is also frequently unreported by sufferers who may consider it shameful or embarrassing.
Physical arousal caused by this syndrome can be very intense and persist for extended periods, days or weeks at a time. Orgasm
can sometimes provide temporary relief, but within hours the symptoms return. The return of symptoms, with the exception of known triggers, is sudden and unpredictable. Failure or refusal to relieve the symptoms often results in waves of spontaneous orgasms in women and ejaculation in men. The symptoms can be debilitating, preventing concentration on mundane tasks. Some situations, such as riding in an automobile
or train
, vibrations from mobile phone
s, and even going to the toilet
can aggravate the syndrome unbearably causing the discomfort to verge on pain. It is not uncommon for sufferers to lose some or all sense of pleasure over the course of time as release becomes associated with relief from pain rather than the experience of pleasure.
A Dutch study has connected PSAS with restless legs syndrome
.
, and note that the disorder has a tendency to strike post-menopausal
women, or those who have undergone hormonal treatment
. It can affect a person at any age.
Some drugs such as trazodone
may cause priapism (which is recognized medical condition, unlike PGAD) as a side effect, in which case discontinuing the medication may give relief. Additionally, the condition can sometimes start only after the discontinuation of SSRIs. In some recorded cases, the syndrome was caused by or can cause a pelvic arterial-venous malformation with arterial branches to the penis
or clitoris
; surgical treatment was effective in this case.
In other situations where the cause is unknown or less easily treatable, the symptoms can sometimes be reduced by the use of antidepressant
s, antiandrogen
ic agents and anaesthetising gels. Psychotherapy
with cognitive reframing
of the arousal as a healthy response may also be used.
More recently, the symptoms of the condition have also been linked with pudendal nerve entrapment
. Regional nerve block
s and less common surgical intervention have demonstrated varying degrees of success in most cases. There is, however, no evidence for the long-term efficacy of surgical intervention.
In one recent case, serendipitous relief of symptoms was noted from treatment with varenicline, a treatment for nicotine
addiction.
Sexual arousal
Sexual arousal, or sexual excitement, is the arousal of sexual desire, during or in anticipation of sexual activity. Things that precipitate human sexual arousal are called erotic stimuli, or colloquially known as turn-ons. There are many potential stimuli, both physical or mental, which can cause...
, with or without orgasm
Orgasm
Orgasm is the peak of the plateau phase of the sexual response cycle, characterized by an intense sensation of pleasure...
or genital engorgement, unrelated to any feelings of sexual desire. It was first documented by Dr. Sandra Leiblum
Sandra Leiblum
Sandra Risa Leiblum was an American author, lecturer, and researcher in sexology.-Biography:Leiblum was born in Brooklyn, NY and graduated with a Ph.D. in psychology from the University of Illinois, Urbana-Champaign, Illinois. She completed a postdoctoral fellowship at the University of Colorado...
in 2001, only recently characterized as a distinct syndrome
Syndrome
In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms , phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others...
in medical literature with a comparable counterpart increasingly reported by men. Some physicians use the term Persistent Sexual Arousal Syndrome to refer to the condition in women; others consider the syndrome of priapism
Priapism
Priapism is a potentially harmful and painful medical condition in which the erect penis or clitoris does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours. There are two types of priapism: low-flow and high-flow. Low-flow...
in men to be the same disorder. Priapism is a recognized diagnosable medical condition by the DSM-IV, whereas PGAD is not. In particular, it is not related to hypersexuality
Hypersexuality
Hypersexuality is extremely frequent or suddenly increased sexual urges or sexual activity. Hypersexuality is typically associated with lowered sexual inhibitions. Although hypersexuality can be caused by some medical conditions or medications, in most cases the cause is unknown...
, sometimes known as nymphomania or satyriasis. Hypersexuality, nymphomania and satyriasis are also not recognized diagnosable medical conditions by the DSM-IV. In addition to being very rare, the condition is also frequently unreported by sufferers who may consider it shameful or embarrassing.
Physical arousal caused by this syndrome can be very intense and persist for extended periods, days or weeks at a time. Orgasm
Orgasm
Orgasm is the peak of the plateau phase of the sexual response cycle, characterized by an intense sensation of pleasure...
can sometimes provide temporary relief, but within hours the symptoms return. The return of symptoms, with the exception of known triggers, is sudden and unpredictable. Failure or refusal to relieve the symptoms often results in waves of spontaneous orgasms in women and ejaculation in men. The symptoms can be debilitating, preventing concentration on mundane tasks. Some situations, such as riding in an automobile
Automobile
An automobile, autocar, motor car or car is a wheeled motor vehicle used for transporting passengers, which also carries its own engine or motor...
or train
Train
A train is a connected series of vehicles for rail transport that move along a track to transport cargo or passengers from one place to another place. The track usually consists of two rails, but might also be a monorail or maglev guideway.Propulsion for the train is provided by a separate...
, vibrations from mobile phone
Mobile phone
A mobile phone is a device which can make and receive telephone calls over a radio link whilst moving around a wide geographic area. It does so by connecting to a cellular network provided by a mobile network operator...
s, and even going to the toilet
Toilet
A toilet is a sanitation fixture used primarily for the disposal of human excrement, often found in a small room referred to as a toilet/bathroom/lavatory...
can aggravate the syndrome unbearably causing the discomfort to verge on pain. It is not uncommon for sufferers to lose some or all sense of pleasure over the course of time as release becomes associated with relief from pain rather than the experience of pleasure.
A Dutch study has connected PSAS with restless legs syndrome
Restless legs syndrome
Restless legs syndrome or Willis-Ekbom disease is a neurological disorder characterized by an irresistible urge to move one's body to stop uncomfortable or odd sensations. It most commonly affects the legs, but can affect the arms, torso, and even phantom limbs...
.
Possible causes and treatment
There is not enough known about persistent genital arousal disorder to definitively pinpoint a cause. Medical professionals think it is caused by an irregularity in sensory nervesSensory nerves
Sensory nerves are nerves that receive sensory stimuli, such as how something feels and if it is painful, smooth, rough, etc.They are made up of nerve fibers, called sensory fibers .Sensory neurons are neurons that are activated by sensory input Sensory nerves are nerves that receive sensory...
, and note that the disorder has a tendency to strike post-menopausal
Menopause
Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining...
women, or those who have undergone hormonal treatment
Hormone replacement therapy (menopause)
Hormone replacement therapy is a system of medical treatment for surgically menopausal, perimenopausal and to a lesser extent postmenopausal women...
. It can affect a person at any age.
Some drugs such as trazodone
Trazodone
Trazodone is an antidepressant of the serotonin antagonist and reuptake inhibitor class. It is a phenylpiperazine compound...
may cause priapism (which is recognized medical condition, unlike PGAD) as a side effect, in which case discontinuing the medication may give relief. Additionally, the condition can sometimes start only after the discontinuation of SSRIs. In some recorded cases, the syndrome was caused by or can cause a pelvic arterial-venous malformation with arterial branches to the penis
Penis
The penis is a biological feature of male animals including both vertebrates and invertebrates...
or clitoris
Clitoris
The clitoris is a sexual organ that is present only in female mammals. In humans, the visible button-like portion is located near the anterior junction of the labia minora, above the opening of the urethra and vagina. Unlike the penis, which is homologous to the clitoris, the clitoris does not...
; surgical treatment was effective in this case.
In other situations where the cause is unknown or less easily treatable, the symptoms can sometimes be reduced by the use of antidepressant
Antidepressant
An antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. According to Gelder, Mayou &*Geddes people with a depressive illness will experience a therapeutic effect to their mood;...
s, antiandrogen
Antiandrogen
Antiandrogens, or androgen antagonists, first discovered in the 1960s, prevent androgens from expressing their biological effects on responsive tissues. Antiandrogens alter the androgen pathway by blocking the appropriate receptors, competing for binding sites on the cell's surface, or affecting...
ic agents and anaesthetising gels. Psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
with cognitive reframing
Cognitive restructuring
Cognitive restructuring, sometimes used synonymously with Debating, is the process of learning to identify irrational or maladaptive thoughts and challenge their veracity using strategies such as logical disputation....
of the arousal as a healthy response may also be used.
More recently, the symptoms of the condition have also been linked with pudendal nerve entrapment
Pudendal nerve entrapment
Pudendal nerve entrapment , also known as Alcock canal syndrome, is an uncommon source of chronic pain, in which the pudendal nerve is entrapped or compressed. Pain is positional and is worsened by sitting...
. Regional nerve block
Nerve block
Regional nerve blockade, or more commonly nerve block, is a general term used to refer to the injection of local anesthetic onto or near nerves for temporary control of pain. It can also be used as a diagnostic tool to identify specific nerves as pain generators...
s and less common surgical intervention have demonstrated varying degrees of success in most cases. There is, however, no evidence for the long-term efficacy of surgical intervention.
In one recent case, serendipitous relief of symptoms was noted from treatment with varenicline, a treatment for nicotine
Nicotine
Nicotine is an alkaloid found in the nightshade family of plants that constitutes approximately 0.6–3.0% of the dry weight of tobacco, with biosynthesis taking place in the roots and accumulation occurring in the leaves...
addiction.