Persistent genital arousal disorder: Successful treatment with leuprolide (antiandrogen)

Deka, Kamala; Dua, Neha; Kakoty, Monali; Ahmed, Rina Dutta

doi:10.4103/0019-5545.166633

Cited by 13 publications

(11 citation statements)

References 9 publications

(12 reference statements)

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“…This treatment regimen was in consonance with the treatment given by Deka et al, who successfully treated 53-year-old widow with Clomipramine, Fluoxetine, Clonazepam and Leuprolide. 17 In our case, the age of the patient was 19 years and we initially used fluoxetine but had no response. It was stopped and then Pramipexole (dopamine agonist) was given.…”

Section: Discussionmentioning

confidence: 69%

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Pramipexole with leuprolide: a treatment strategy for PGAD

Raj

Bhagat

2017

Int J Basic Clin Pharmacol

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Persistent genital arousal disorder (PGAD) is described as the spontaneous, intrusive, and unwanted genital arousal in the absence of sexual interest and desire. Whether, its etiology is central or peripheral neurovascular in nature, it is still unclear. However, patient presents with symptoms of persistent engorgement of genital erectile and vascular tissue. The majority of women report PGAD as distressing. The symptoms usually occur in females in the age group 25-58 years especially in perimenopausal phase. The case is reported of PGAD in 19-year old female who was treated successfully with Pramipexole and Leuprolide.

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Section: Discussionmentioning

confidence: 69%

“…Deka et al, reported treatment of PGAD with Leuprolide. [11][12][13][14][15][16][17] The psychological intervention includes cognitive behavioral therapy (CBT) and mindfulnessbased therapies (MBT). [18][19][20] The case of 19-year unmarried female is reported who suffered from PGAD and responded successfully to Pramipexole with Leuprolide.…”

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confidence: 99%

Pramipexole with leuprolide: a treatment strategy for PGAD

Raj

Bhagat

2017

Int J Basic Clin Pharmacol

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“…In women with PGAD, there are case reports of use of weak GnRH receptor agonists (eg, leuprolide) that desensitize the receptors and thereby inhibit gonadotropin secretion. 155,170 These agents, which indirectly induce sex steroid hormone deprivation, may act by reducing feelings of genital arousal, but there are numerous side effects to this therapy, especially in younger women. These side effects include hot flashes, headaches, osteoporosis, vaginal atrophy, and suppression of ovulation and menses in reproductive-age women.…”

Section: Region 5: Brainmentioning

confidence: 99%

International Society for the Study of Women’s Sexual Health (ISSWSH) Review 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)

Goldstein

Komisaruk

Pukall

et al. 2021

The Journal of Sexual Medicine

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Background: Persistent genital arousal disorder (PGAD), a condition of unwanted, unremitting sensations of genital arousal, is associated with a significant, negative psychosocial impact that may include emotional lability, catastrophization, and suicidal ideation. Despite being first reported in 2001, PGAD remains poorly understood. Aim: To characterize this complex condition more accurately, review the epidemiology and pathophysiology, and provide new nomenclature and guidance for evidence-based management. Methods: A panel of experts reviewed pertinent literature, discussed research and clinical experience, and used a modified Delphi method to reach consensus concerning nomenclature, etiology, and associated factors. Levels of evidence and grades of recommendation were assigned for diagnosis and treatment. Outcomes: The nomenclature of PGAD was broadened to include genito-pelvic dysesthesia (GPD), and a new biopsychosocial diagnostic and treatment algorithm for PGAD/GPD was developed. Results: The panel recognized that the term PGAD does not fully characterize the constellation of GPD symptoms experienced by patients. Therefore, the more inclusive term PGAD/GPD was adopted, which maintains the primacy of the distressing arousal symptoms and acknowledges associated bothersome GPD. While there are diverse biopsychosocial contributors, there is a common underlying neurologic basis attributable to spontaneous intense activity of the genito-pelvic region represented in the somatosensory cortex and its projections. A process of care diagnostic and treatment strategy was developed to guide the clinician, whenever possible, by localizing the symptoms as originating in any of five regions: (i) end organ, (ii) pelvis/perineum, (iii) cauda equina, (iv) spinal cord, and (v) brain. Psychological treatment strategies were considered critical and should be performed in conjunction with medical strategies. Pharmaceutical interventions may be used based on their site and mechanism of action to reduce patients' symptoms and the associated bother and distress. Clinical Implications: The process of care for PGAD/GPD uses a personalized, biopsychosocial approach for diagnosis and treatment. Strengths and Limitations: Strengths and Limitations: Strengths include characterization of the condition by consensus, analysis, and recommendation of a new nomenclature and a rational basis for diagnosis and treatment. Future investigations into etiology and treatment outcomes are recommended. The main limitations are the

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“…risperidone, quetiapine). [5][6][7][8]12 Zolpidem is a non-benzodiazepine indirect GABA A receptor agonist. Its sedative-hypnotic and anticonvulsive activities seem to be due to its action on a1-GABA A receptors and not on the rest of GABA A receptors (a2 or a3).…”

Section: Introductionmentioning

confidence: 99%

Zolpidem related persistent genital arousal disorder: An interesting case

et al. 2020

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T he present paper is describing a case of persistent genital arousal disorder that developed to a 55-year-old woman, shortly after the initiation of zolpidem. Persistent genital arousal disorder (PGAD) is a clinical entity that appears with a relatively low frequency in women, and is characterized by persistent or recurrent, unwanted and bothersome feelings of genital arousal, which often do not resolve with orgasm and are not associated with sexual desire (sexual interest, thoughts or fantasies). Women who experience PGAD often have feelings of shame, guilt and distress. Although its exact etiology remains unclear, various etiological factors have been proposed, central or peripheral, which may be psychological, vascular, dietary, pharmacological or neurological. Additionally, its presence has been associated to restless legs syndrome and overactive bladder syndrome. Likewise, multiple therapeutic interventions have been proposed and tried in patients with PGAD, either pharmacological (SSRIs, SNRIs, antiandrogens, benzodiazepines, antipsychotics, anticonvulsive agents) or other (ECT, physiotherapy, psychotherapy, nerve stimulation). Zolpidem is a nonbenzodiazepine indirect GABA A receptor agonist, which has lately been used as a therapeutic agent for PGAD in some cases. Nevertheless, in our patient, receiving zolpidem for insomnia seemed to be timely connected to the onset of PGAD symptomatology. The aim of the present paper is to highlight the need for more research into the possible factors that may contribute to PGAD.

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Persistent genital arousal disorder: Successful treatment with leuprolide (antiandrogen)

Cited by 13 publications

References 9 publications

Pramipexole with leuprolide: a treatment strategy for PGAD

Pramipexole with leuprolide: a treatment strategy for PGAD

International Society for the Study of Women’s Sexual Health (ISSWSH) Review 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)

Zolpidem related persistent genital arousal disorder: An interesting case

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