Persistent Genital Arousal: Disordered or Normative Aspect of Female Sexual Response?

Abstract

Introduction Persistent genital arousal disorder (PGAD), previously known as persistent sexual arousal syndrome, is a serious and extremely distressing condition. Clinical experience suggests that there may be a subset of women who experience persistent genital arousal as a normative and not especially distressing part of their sexuality. Aim To determine whether there are women who report unprovoked genital arousal and view it as normative, and to identify differences between women who endorse all five features of PGAD vs. those who endorse only some of features. Main Outcome Measures Respondents were asked about the nature, onset, duration, and severity of their arousal, and their feelings about PGAD. Overall sexual and relationship satisfaction was assessed, as were scores on the Female Sexual Function Index (FSFI). Methods An on-line, anonymous survey on persistent genital arousal was conducted. Of the 388 respondents, 206 women endorsed all five features of PGAD (PGAD group) and 176 endorsed some, but not all, criteria (non-PGAD group). Results The two groups were similar in age, relationship status, and duration. More PGAD than non-PGAD women reported current symptoms and greater symptom severity. Distress ratings were significantly greater for PGAD than non-PGAD women (7.9 vs. 4.7 on a 10-point scale). Forty-eight percent of PGAD vs. 27% of non-PGAD women reported continuous feelings of arousal. Significantly more PGAD women than non-PGAD women endorsed negative feelings about their genital arousal. Women with PGAD reported lower desire, less sexual satisfaction, greater pain, and lower overall scores on the FSFI. Conclusion There is a cohort of women who regularly, if intermittently, experience unprovoked and persistent genital arousal and find it mildly pleasurable. Their genital arousal differs from that of women who meet all five criteria for a diagnosis of PGAD. Possible explanations and etiologies for these differing reactions are discussed.

A woman with a high capacity for multi-orgasms: a non-clinical case-report study

“…Calling this non-clinical is also meant to emphasize the difference between the experience we present and Persistent Sexual Arousal Syndrome (Graziottin, Dennerstein, Alexander, Giraldi, & Wipple, 2006) or Persistent Genital Arousal Disorder (Leiblum & Chivers, 2007) that are described in the medical literature (Basson et al, 2004;Graziottin et al, 2006;Leiblum, Brown, Wan, & Rawlinson, 2005). The phenomena described in this paper also does not fit the more recent description of spontaneous genital arousal that is neutral or even pleasuring (Leiblum & Chivers, 2007;Leiblum, Seehuus, & Brown, 2007). The subject's motivation for sexual expression and pleasure did not seem to stem from a genital ''itch'' or ''throb'', but rather from her desire, which was described as voluntary and under her control.…”

Transtorno da excitação genital persistente: uma revisão da literatura

“…Leiblum et al 27,32 e Leiblum e Chivers 33 , em seus estudos, perceberam que muitas mulheres relatam respostas fisiológicas de excitação espontânea, mas nem todas as interpretam negativamente. Isso evidencia que a ansiedade possui um papel determinante na manutenção do quadro, aumentando ainda mais a consciência dessas mulheres em relação a pequenas alterações fisiológicas em sua região genital.…”

“…Todas as iniciativas sexuais se davam não em busca do prazer, mas, sim, de alívio dos sintomas genitais, que eram extremamente perturbadores. Com isso, Leiblum passou a considerar o problema como de ordem genital mais do que sexual, renomeando a condição para "persistent genital arousal disorder", ou transtorno da excitação genital persistente (TEGP) 32 . Baseado em seus achados, Waldinger propôs que o TEGP seja incluído em um espectro de doenças juntamente com a SPI e a síndrome da bexiga hiperativa 25 .…”

“…Leiblum descreveu dois subtipos do transtorno 32 : um grupo de mulheres que interpreta esses sintomas como parte de sua natureza sexual, sem avaliações negativas a respeito deles. Ela chamou esse grupo de Não TEGP, ou seja, as mulheres, apesar de relatarem os sintomas característicos, não os avaliavam como aflitivos ou intrusivos.…”

Female Sexual Arousal Disorders

“…In addition to the lack of sexual arousal in sexual circumstances that characterizes FSAD, women may also suffer from a persistent, unwanted, and distressing increase in genital blood flow in nonsexual circumstances. Persistent genital arousal disorder (PGAD), perhaps more appropriately called Restless Genital Syndrome (ReGS) [108], is a relatively new sexual health concern in women [108–131], having been proposed only a decade ago by Leiblum and Nathan [119]and subsequently as PGAD by Goldmeier and Leiblum [112]. ReGS/PGAD is characterized by five diagnostic criteria: (i) involuntary genital and clitoral arousal that persists for an extended period of time (hours, days, months); (ii) the physical genital arousal does not go away following one or more orgasms; (iii) the genital arousal is unrelated to subjective feelings of sexual desire; (iv) the persistent feelings of genital arousal feel intrusive and unwanted; and (v) there is distress associated with the persistence of the genital arousal [110].…”