A reader from US, who wishes to remain anonymous, asks: I am suffering from Persistent Genital Arousal Disorder (PGAD). I am a student of homeopathy and have had my personal homeopath, who is also an M.D. When the almost intolerable symptoms of this (PGADS) condition first began suddenly and started ruining my life! (this is how it truly feels), I went to my homeopathic doctor for help. He prescribed a single remedy and when this had no improving effect at all, he basically gave up and told me that he was not able to help me.
I will not go into the long list of attempts to get help and the various medical people I have consulted. This has been going on for over two years and I am feeling real despair! There has been some slight improvement, but this is erratic as symptom gets better and worse, then again better and worse.
PLEASE, is there anyone who can help or suggest any way I can get cured and free myself from this insanity and get my life back? I would be deeply, sincerely, grateful. (I am so poor at this point from using almost all my resources trying to get help for this sickness).
Dr Dinesh Kartha ( Ministry of Health Approved Naturopathic Medicine Practitioner, Chief Consultant and Managing Partner, Aura Alternative Medicine Center, Sharjah, UAE) replies: You have mentioned that you have been diagnosed with Persistent Genital Arousal Disorder (PGAD). But you have not pointed out how you arrived at this conclusion. Persistent genital arousal disorder (PGAD), originally called Persistent sexual arousal syndrome (PSAS) and also known as Restless genital syndrome (ReGS or RGS), results in a spontaneous, persistent, and uncontrollable genital arousal in women, with or without orgasm or genital engorgement, unrelated to any feelings of sexual desire. It occurs apart from any of the physical or psychological stimuli that trigger normal arousal. The physiological characteristics of sexual arousal persists for hours to days, do not subside by itself and also it may be triggered not only by sexual stimuli, but also by nonsexual stimuli or by no apparent stimuli at all.
More details about your symptoms are required as there are many other symptoms associated with PGAD.
- These symptoms may be accompanied by pain.
- Patients with the condition often report orgasmic feelings in other parts of the body like urethra and anus are mentioned very often. Also the belly, loins, feet and/or toes are often reported.
- The symptoms have a serious effect on their daily lives, demanding an enormous amount of energy, often leading to chronic fatigue, depression, isolation and not seldom to suicidal thoughts.
- Due to shame, guilt and fear of rejection, patients may withdraw from society and are at risk of becoming isolated.
Causes
Allen Masters Syndrome: This is caused by damage to pelvic muscles, which in turn lead to abnormally increased movement of cervix. It often occurs after a traumatic child birth or induced abortion. Women with PSAS may have this syndrome. The pelvic and sexual organs are rich in blood supply. Women with this syndrome has venous congestion of blood in pelvic region. The chronically dilated varicose veins do not respond well to neurologic and hormone signals to contract to normal size especially after the resolution phase of the sexual cycle leading to persistent arousal.
Tarlov cysts may be a possible cause , they are perineural cysts that are abnormal sacs filled with cerebrospinal fluid which form at the lower end of the spine (sacrum), at the S1-to-S4 region of the spinal cord.
Tourette’s syndrome: Tourette’s syndrome is a neurological disorder characterised by compulsive, repetitive, steroetyped, involuntary movements and vocalisations called tics. The most common tics are of eye blinking, coughing, throat clearing, sniffing, and facial movements. PSAS may be a variant of such a disorder that is associated with compulsive masturbation and intrusive thoughts. There may be a family history of Tourette’s syndrome as well.
Hypersensitivity of some nerves can be another cause. The hypersensitivity may result after some minor trauma to pelvic nerves or after an episode of neurological conditions such as meningitis or encephalitis. The glans penis of male has 4,000 nerve endings and in comparison the equivalent smaller female clitoris has 8,000 such nerve endings. PSAS may be caused by pudendal neuropathy or neuropathy of the dorsal nerve of clitoris (DNC).
Endocrinal PSAS: Women who suffer from the condition are hyper sensitive to the arousal effect of progesterone. Usually it is seen after menopause or in the initial days of menstrual cycle.
Prolactin release disorder: Prolactin has a role in maintaining the refractory and relief phase after orgasm. Men take more time to be aroused the second time because they release more prolactin after orgasm. Women have a shorter refractory period due to a smaller release of the hormone. In PSAS, it is possible that there maybe no release or delayed release of the prolactin hormone.
Oxytocin deficiency: Oxytocin release from pituitary in orgasm gives the calming effect. It reduces stress and its release in clitoral orgasm is even more. Reduced oxytocin levels can hence lead to persistent arousal.
Diagnosis
Prof. Sandra R. Leiblum, who documented the condition first in 2001, listed 5 criteria for a diagnosis of PGAD. Never assume you have PGAD if you do not have the following:
- Involuntary genital and clitoral arousal that continues for an extended period (hours, days, months).
- No cause for the persistent genital arousal can be identified.
- The genital arousal is not associated with feelings of sexual desire.
- The persistent sensations of genital arousal feel intrusive and unwanted.
- After one or more orgasms, the physical genital arousal does not go away.
Treatment
Medical history and Psychological profile also should be carefully studied before deciding a treatment. Researchers also advise doctors treating PGAD cases to subject their patients to physical examination, neurologic sensation testing and to take blood tests before and after the genital arousal. Talk with your physician to find out whether you have to undergo any additional tests to find out the root cause. Psycho-educational interventions, cognitive-behavioral therapy and physiotherapy or stretching exercises can be tried.
You should be convinced that it is a medical condition and not merely a behavioural or psychological problem and you are not alone in the struggle. Understand that there are many others undergoing the same condition.
Avoiding Triggers: Avoid activities that exert pressure in the genital region like long time continuos sitting and biking. Also try to figure out that all body positions do trigger the symptoms and avoid them. Tight clothing and under-wears must be avoided.
Divert your mind: Indulge in activities that would divert your mind from arousal. Engage in an activity you are really interested in. Try to find time for your hobbies.
Pelvic massage or stretching exercises may reduce or eliminate pelvic floor tension and break up whatever connective tissue strictures contribute to the PGAD.
Cold compresses may help temporarily as it may numb the genital area for sometime.
Swimming and relaxing hot tubs also have found to have a calming effect.
Cognitive-Behavioral Interventions: Will help you to identify the problem, challenge pessimistic thoughts and replacing them with more adaptive and positive cognitions and thus to self-manage the problem.
Natural & Herbal supplements: Herbal Supplements like Passion Flower, Kava Kava, Valerian Root, St. John’s Wart, Grapes, Holy Basil and Lemon Balm can be tried to de-stress yourself. Other supplements like Gamma Amino Butyric Acid(GABA), Phosphatidylserine, Secretin and Vitamin C can be used only under the supervision of a Naturopathy Physician.
Acupuncture: Acupuncture has shown to be effective if PGAD is due to a neurological cause. Additionally acupuncture is used by many to treat hormonal imbalances.
Diet: Better to avoid caffeine and alcohol. Also avoid spicy foods and sprouts that may increase sexual stimulation. Include lot of green leafy vegetables and fruits in your diet.
Yoga and Meditation: Managing your stress levels will definitely reduce severity of symptoms. Regular practice of Yoga and Meditation will definitely help you. Talk with a Yoga-therapist and find out which stretching practices will be ideal for you.
Homeopathic treatment
Dr Rosamma Sabu, (licenced homeopathic practitioner, Al Balsam Homeopathic Centre, Sharjah, UAE) replies: 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.
In particular, it is not related to hyper-sexuality, sometimes known as nymphomania or satyriasis. (Hyper-sexuality, nymphomania, and satyriasis are also not recognized diagnosable medical conditions by the DSM-IV.) In addition to being very rare, PGAD is also frequently unreported by sufferers who may consider it shameful or embarrassing. A lack of seriousness in society regarding the human reproductive system downplays the intense pain of the sufferer.
Homeopathic materia medica have medications for this. Personally I have not come across a single case. I have colleagues who have successfully treated this condition in homeopathy.
Disclaimer: This blog is a conversation and is not an alternative for treatment. The recommendations and suggestions offered by our panel of doctors are their own and Gulf News will not take any responsibility for the advice they provide.
