Female Sexual Dysfunction and Persistent Genital Arousal Disorder

Jerry Kennard Health Pro
  • The term, persistent genital arousal disorder (PGAD) refers to a problem only recently identified, but which appears to affect many more women than first envisaged. Since first being described by psychiatrist Professor R. Leiblum in 2001, PGAD has attracted the attention of many hundreds of women many of whom express huge relief at finally having their situation recognized.


    Originally called "persistent sexual arousal syndrome" (PSAS), Leiblum now believes the ‘sexual syndrome' element is inaccurate because the problem is not sexual so much as it is an issue of unremitting genital sensations that have no particular cause and which extend over long periods of time.

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    But is there a difference between say being a nymphomaniac or saying you have PGAD? Yes, says Leiblum, who points out that so-called nymphomaniacs always identify sexual thoughts or fantasies and who experience sexual excitement. This is not the case with PGAD, which is described as an uncomfortable, unwelcome intrusion. Women with PGAD experience find no pleasure or enjoyment in their situation and actually feel quite distressed and out of control.


    Emotional distress is a common theme. Women's own accounts of their situation have previously been collated and appear in the July issue of Contemporary Sexuality. One 65 year old talks of PGAD as like, "having a bad itch and nothing or no amount of scratching will stop it . . .when your every working hour feels like you are in the middle of sexual intercourse that never comes to a satisfying end it is a terrible feeling." A 53 year old woman describes how the disorder negatively affects her sexual relationship with her partner. Another 63 year old talks about being a, "case of hormonal rape." Yet others describe having "orgasmic fits" that leave them feeling uncomfortable, disturbed, embarrassed and guilty.


    The causes of this distressing disorder are still unknown. MRI scans show no obvious organic pathology. To date, the women who have come forward tend to be well-educated and in long-term relationships. Some writers have speculated whether the use of selective serotonin reuptake inhibitors (SSRIs) may be responsible as accounts from some women appear to point to changes in medication as the starting point of their problems. However, this is not the case with all women. Professor Leiblum states that the only thing can be said with any certainty is the fact that PGAD appears to be a multi-factorial disorder in which neurovascular, neurochemical and psychological distress and influential.


    There is no generally accepted treatment for PGAD. Certain medications can alleviate the condition but the same medications can worsen the situation in some women. Pelvic massage or stretching can be helpful. Avoidance of "heavy-handed" self-stimulation is not recommended as this simply contributes to greater genital vaso-constriction. Distraction appears to be very important as is anything which helps to provide a sense of calm.


  • An online support forum is available at http://www.psas-support.com/.

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    Jerry Kennard is a psychologist & co-founder of Embarrassments.co.uk.


Published On: August 20, 2008