What is Persistent Genital Arousal Disorder (PGAD)?
Updated: Apr 8
Hi friends! Let’s talk about a condition call Persistent Genital Arousal Disorder (PGAD). This is a condition of unwanted and constant sensation of genital arousal (Goldstein, 2021). While this may seem ideal for individuals not experiencing it, the sensations with PGAD are unwanted and can cause significant disruptions in individuals’ lives. PGAD is associated with high levels of anxiety and distress with 54% of women reporting suicidal thoughts (Goldstein, 2021).
PGAD is diagnosed when the following criteria are met (Goldstein, 2021):
Persistent, unwanted sensation of genital arousal
Symptoms present longer than 3 months
May include other types of dysesthesia (i.e. buzzing, tingling, burning, itching, pain)
Symptoms most commonly present in the clitoris but may also occur in other pelvic regions (i.e. mons pubis, vulva, vagina, urethra, bladder, rectum)
May include being on the verge of orgasm, uncontrollable orgasms, or excess number of orgasms
Not associated with sexual interest, thoughts, or fantasies
PGAD is not well understood but it is believed to be a combination of medical, psychological, and pharmacological factors (Goldstein, 2021). Researchers believe that there is a large neurological component to the disorder (Goldstein, 2021).
One of the medical causes that can contribute to PGAD is overactive pelvic floor muscles. A healthy muscle is able to fully contract (at the right time) and then it’s able to fully relax (at the right time). An overactive pelvic floor muscle is stuck halfway in between the two—it is not relaxing well but it is also not contracting well. It is often painful, stiff, and tight.
Stretching the pelvic floor muscles is an important part of pelvic health that is often overlooked (sometimes we get too focused on strengthening the pelvic floor muscles). Imagine what that does to these muscles overtime! What if you were constantly squeezing your hand into a fist? Overtime, would your hand get stiff, contracted, and not work as well? Absolutely! The same is true for the pelvic floor muscles.
Since treating pelvic pain and overactive pelvic floor muscles is complex, it is recommended to see a pelvic floor physical therapist. A pelvic floor physical therapist can help you learn to control your pelvic floor muscles to contract and relax them at the proper times.
Your therapist can also teach you ways to help relax the pelvic floor muscles like stretches. They can help to address other areas of the body that can play a role in pelvic pain, like the low back and hips.
You can ask your doctor for a referral to a pelvic floor physical therapist near you, or you can find one on www.myPFM.com/find-a-pt.
Whether it is the pelvic floor muscles or other areas of the body, it is important to treat the underlying conditions that are causing PGAD. This may include a combination of treatments to address various aspects. There is hope!
Ready to learn more about your pelvic floor muscles? Here are some helpful resources:
Watch our free YouTube playlist Pelvic Pain and Your Pelvic Floor
Watch Netflix for Your Pelvic Floor at Pelvic Flicks
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics
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Pelvic Floor Therapy Management & Treatment for PGAD/GPD (Persistent genital arousal disorder/genito-pelvic dysesthesia) with April Patterson, PT, MSPT
Anxiety, Depression, and the Overactive Pelvic Floor with Dr. Jill Krapf, MD, Med, FACOG
Written by Emily Reul, PT, DPT
Goldstein I et al. International Society for the Study of Women’s Sexual Health (ISSWSH) reviw of epidemiology and pathophysiology and a consensus nomenclature and process of care for the management of persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD). J Sex Med.2021;18(4):665-697.