By Stephanie Prendergast, MPT, Cofounder, PHRC Los Angeles
Persistent Genital Arousal Disorder (PGAD) is a syndrome characterized by unwanted genital arousal in nonsexual situations and was first described in 2001. The syndrome is being studied and in 2021 the International Society for the Study of Women’s Health (ISSWSH) published new guidelines about PGAD, broadening the term to genito-pelvic dysesthesia (GPD) and offering evidence-based treatment options.
The symptoms occur without the signs of physiological arousal, such as genital engorgement, and are commonly described as buzzing, pain, or itching.
The symptoms are very distressing and bothersome, suffering patients report that they have difficulty participating in professional and personal activities of daily living.
Many patients with PGAD/GPD concurrently suffer from other pain syndromes and sexual dysfunction.
By expanding the definition and studying the syndrome we now know that there are multiple causes for PGAD/GPD and biopsychosocial solutions.
Research shows that there are several reasons people may develop the symptoms of Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD). Like many other syndromes, people may have one or a combination of these underlying factors that are contributing to their symptoms. Some cases are idiopathic, meaning we may not be sure why symptoms developed.
Systemic and local hormone alterations can affect genital sensation and are treatable contributing factors for some people with PGAD/GPD.
Pelvic floor dysfunction is associated with PGAD/GPD. We do not know if it is a cause or an effect but it is often present and a treatable impairment.
Peripheral nerve dysfunction (such as pudendal neuralgia), cauda equina syndrome, and central nervous system dysregulation is another subset of impairments that can be evaluated and treated.
Unfortunately cases of PGAD/GPD have been reported in people going on or off certain medications, including SSRIs.
Most people have a combination of physical factors contributing to their symptoms and also mental health issues as a result of having a condition that their providers may not have heard of. Experts are working to improve diagnosis and treatment algorithms and suffering patients are getting the help they need with a biopsychosocial treatment approach. Unfortunately we know there are more patients than informed providers and are here to help provide education about the syndrome.
Stay tuned for more information about treatment options. If you have questions please reach out to us, you are certainly not alone.
Are you unable to come see us in person in the Bay Area, Southern California or New England? We offer virtual physical therapy appointments too!
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
Melissa Patrick is a certified yoga instructor and meditation teacher and is also available virtually to help, for more information please visit our therapeutic yoga page.
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