Exploring the link between eating disorders and persistent genital arousal disorder/genito-pelvic dysesthesia: first description and a systematic review of the literature

Abstract

Background Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD) characterized by recurrent physiological genital without corresponding psychological arousal is a poorly understood and researched condition. Based on the first two case descriptions of eating disorders directly linked to PGAD/GPD the aim of this paper was to systematically review the literature on possible associations between eating disorders and PGAD/GPD. Method A systematic literature search on eating disorders and PGAD/GPD was conducted in PubMed, PsycINFO, and Scopus, complemented by Google Scholar. We included case reports, case series, cross-sectional studies and review articles published in peer-reviewed journals written in English or German-language. Results The included original papers described a total of 2078 cases with PGAD/GPD symptomatology. Of these, 892 participants fulfilled all five PGAD/GPD core criteria. The aetiology of PGAD/GPD is unknown. Multifactorial genesis of PGAD/GPD is presumed including neurological, pharmacological, hormonal, vascular and psychological causes. A high degree of psychological comorbidity is reported. No study was found that drew a direct link between eating disorders and PGAD/GPD. Although PGAD/GPD symptoms also occur in adolescents, there are no findings in this regard. However, we found a gap in data collection: eating disorders as potential psychiatric comorbidities were systematically recorded in only a few studies. Conclusion The existing literature have not yet considered a possible link between eating disorders and PGAD/GPD so far. According to the authors’ knowledge, this work is the first review to systematically explore the associations. We suspect underreporting of PGAD/GPD cases in eating disorders and particularly during adolescence. We argue that there are several common factors that appear to be important in the etiology, course, and treatment of both disorders (e.g. hormonal dysregulation or sensory sensitivity and avoidance), warranting future research on the possible comorbidity of these disorders.

Persistent genital arousal disorder: clinical, differential diagnostic and care aspects (clinical report)

“…Some studies indicate a correlation between the onset of PGAD symptoms and taking or stopping antidepressants including SSRIs [10,11]. In the case we described, the correlation between discontinuation of an antidepressant and the beginning of symptoms and their disappearance when the drugs of this class are re-prescribed is clearly observed.…”

A review of persistent genital arousal disorder: Symptoms, diagnosis, and treatment

“…In 2001, the first case of PGAD was identified, but its exact nature is still not understood. Females are also mostly affected by eating disorders, which are serious mental issues (Imgart et al, 2022). They mostly cause physical side effects in addition to a high occurrence of psychosocial features (Zhang et al, 2022).…”