Persistent Genital Arousal Disorder: A Guide

Medically Reviewed By Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
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Persistent genital arousal disorder (PGAD) is a condition that involves excessive and unwanted physical arousal without a desire for sexual activity. This article defines PGAD. It also discusses the symptoms, causes, and treatment of the condition.

What is persistent genital arousal disorder?

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Persistent genital arousal disorder (PGAD) is a condition that causes symptoms of physical arousal even when there is no desire for sexual activity. PGAD can affect anyone, but it is more common among those assigned female at birth.

PGAD also has a psychological impact on those who experience it. Studies suggest that PGAD has a high co-occurrence with mental health conditions such as:

  • worry
  • stress
  • emotional lability
  • catastrophizing
  • suicide ideation

If someone you know is at immediate risk of harming themselves or others or at risk of suicide: 

  • Ask the question, “Are you considering suicide?” even if it is tough.
  • Listen without judgment.
  • Call 911 or your local emergency number. 
  • Stay with them until emergency services arrive.
  • Try to remove any weapons, medications, or other potentially harmful items.

If you or someone you know is having suicidal thoughts, contact the National Suicide Prevention Lifeline:

  • Call 988.
  • Chat with the lifeline.

This service is available 24-7. 

Due to the chronic and involuntary nature of PGAD, it can have an effect on day-to-day life. For example, it can make activities such as working, socializing, and driving more difficult. It can also have a negative impact on relationships and sexual satisfaction.

What are the symptoms of persistent genital arousal disorder?

Symptoms of persistent genital arousal disorder (PGAD) are generally either constant or intermittent. Some people with PGAD may have periods of time when they do not experience any symptoms at all, followed by periods of time when their symptoms flare up.

Some common symptoms of PGAD include:

  • unremitting genital arousal that is:
    • involuntary
    • unwanted, intrusive, or bothersome
    • not related to sexual thoughts, interests, or fantasies
    • aggravated or not resolved by orgasm
  • feeling as though you are constantly on the verge of orgasm
  • tingling, pulsating, or throbbing of your genitals that is consistent
  • pain, pressure, or discomfort in your genitals
  • shame, anxiety, or distress about your condition

PGAD only became a known disorder recently. This means that not much is known about it compared with other forms of sexual dysfunction. For this reason, someone with PGAD may experience symptoms that are not listed here.

If you experience these or any other symptoms that cause you concern, contact your doctor.

Learn more about sexual dysfunction here.

What causes persistent genital arousal disorder?

Persistent genital arousal disorder (PGAD) is most likely due to a combination of factors. Some of the factors that may cause someone to develop PGAD include their:

  • biology
  • psychology
  • social or cultural background
  • medication history

Issues within the central nervous system may also contribute to the development of PGAD. This is sometimes because a nerve root in the lower back becomes irritated due to an injury. This causes the nerve to fire without permission, thus sending sensory information to the genital region. This makes your body believe that these are signals of arousal.

It is also possible that certain neurochemicals in your brain may play a role in the development of PGAD.

Likewise, some people believe that suddenly stopping or starting selective serotonin reuptake inhibitors (SSRIs) may also contribute to the development of PGAD.

Other possible causes of PGAD include:

  • pelvic floor muscle dysfunction
  • pudendal neuropathy
  • lumbar annular tear
  • sacral Tarlov cysts

How do doctors diagnose persistent genital arousal disorder?

Diagnosis of persistent genital arousal disorder (PGAD) is typically based on the characteristic symptoms. However, sometimes, a doctor only gives a diagnosis if the symptoms are causing distress.

Generally, your doctor will base their diagnosis on your medical history, a physical exam, and any laboratory tests they deem necessary. These tests may include testing for thyroid and sex hormone levels. Your doctor may also order vascular or neuro-genital testing.

Persistent genital arousal disorder vs. priapism

Persistent genital arousal disorder (PGAD) typically affects people assigned female at birth, while priapism affects those with a penis. Priapism causes prolonged erections without stimulation.

The exact duration of an erection to warrant a diagnosis of priapism varies. However, on average, any erection lasting longer than 4 hours is considered priapism.

Priapism is often considered a medical emergency. Early treatment is essential in order to recover the ability to get and maintain an erection. Without this treatment, priapism can cause the tissue in the penis to die. This can then lead to permanent erectile dysfunction.

If you have a prolonged erection that lasts longer than 4 hours, contact your doctor right away.

Learn more about erectile dysfunction.

How do you treat persistent genital arousal disorder?

There is no single treatment option for persistent genital arousal disorder (PGAD). However, most experts agree that a biopsychosocial approach is the most effective approach to treatment. This means an interdisciplinary approach that focuses on the connections between biology, psychology, and socio-environmental factors.

Treatments for PGAD may include:

  • undergoing psychotherapy
  • trying pelvic floor therapy
  • either starting SSRIs or adjusting the dose
  • treating underlying conditions, such as Tarlov cysts

Work with your doctor to find the most effective treatment option for your individual circumstances.

Summary

Persistent genital arousal disorder (PGAD) is a condition that causes persistent genital arousal without stimulation or the desire for sexual activity. The arousal that is due to PGAD is often aggravated or not relieved by orgasm.

PGAD can cause distress in those who experience it. This can lead to worry, stress, or embarrassment. PGAD can also cause issues in relationships and problems with sexual satisfaction.

If you are experiencing any symptoms of PGAD, contact your doctor.

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Medical Reviewer: Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
Last Review Date: 2022 Jul 29
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.