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Persistent Genital Arousal Disorder

by Rosemary Basson, MD

Persistent genital arousal disorder is excessive unwanted physical (genital) arousal, involving increased blood flow to the genital organs and increased vaginal secretions, without any desire for sexual activity.

What causes this disorder is unknown. However, anxiety and worry about when the disorder will recur may perpetuate it. Tight pelvic muscles may be part of the cause.

Physical changes that are usually triggered by sexual stimulation occur even though the woman has no wish to engage in sexual activity and is not mentally or emotionally (subjectively) aroused. Blood flow to the genital area increases, causing the clitoris (which corresponds to the penis in men) and vaginal walls to swell (a process called engorgement). The increased blood flow causes vaginal secretions (which provide lubrication) to increase. The genital area may tingle or throb. The sensations persist for hours or days. Most women consider these changes intrusive and are distressed and embarrassed by them.

At first, orgasms (including self-stimulated ones) may bring temporary relief, but they often become less effective, as well as being an unsatisfactory, impractical solution.

Treatment

Treatment is unclear. Pelvic muscle relaxation exercises with biofeedback (see Mind-Body Techniques : Biofeedback) may help, especially when combined with mindfulness-based cognitive therapy (MBCT—see Treatment). Mindfulness involves focusing on what is happening in the moment. MBCT combines mindfulness and cognitive-behavioral therapy.

Simple recognition of the existence of this disorder, with reassurance that it can spontaneously resolve, may help some women. Information about the disorder and support are also helpful, as can specific treatment of anxiety, including psychologic therapies and/or drugs.