Persistent genital arousal: Differential diagnosis and management in the emergency room of psychiatry

Abstract

Background

We describe the case of a 50 years old woman who attended the emergency room for complaints that involves continuous orgasms in the last two months that she describes “as waves”. The woman is a widow and claims not to have had sexual relationships since her husband died four years ago.

Main objective

Persistent genital arousal disorder (PGAD) is a relatively unknown clinical condition affecting several women. Moral standards, as well as conservative beliefs regarding sexuality, are believed to be involved in the etiology and maintenance of this syndrome. Nevertheless, there are no consistent data on the content of the beliefs system presented by these women.

PGAD It has been identified as a condition of often unprovoked genital arousal associated with a significant level of distress.

PGAD is not well understood, and no definitive cause has been determined.

Our main objective was to review the literature on PGAD, identify possible causes of the disorder, and provide approaches to the assessment and treatment of the disorder based on the authors’ experience and recent literature.

Comments

PGAD is a potentially debilitating disorder of unwanted genital sensation and arousal that is generally spontaneous and unrelenting. Since its first description in 2001, many potential etiologies and management strategies have been suggested. PGAD likely represents a range of conditions manifesting in unwanted genital sensations. Successful treatment requires a multidisciplinary approach and consideration of all reversible causes as well as cognitive therapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.