Persistent Genital Arousal Disorder
Cause is unknown. Anxiety and hypervigilance for recurrence of pain episodes may perpetuate the syndrome. Symptoms are currently thought to result from pelvic muscle hypertonicity.
Unwanted, intrusive, spontaneous genital arousal (eg, tingling, throbbing) occurs, without any sexual desire or subjective arousal.. The sensations persist for hours or days and typically cause great distress. Older women, especially, may be very embarrassed by the symptoms.
Treatment is unclear. Self-stimulation to orgasm may provide relief initially, but this treatment usually becomes less effective over time, and most women find this treatment distressing.
Pelvic muscle physical therapy with biofeedback may help, especially when it is combined with mindfulness-based cognitive therapy (see Treatment). High-dose SSRI therapy has been reported effective, but data are few.
Simple recognition of the existence of this disorder, with reassurance that it can spontaneously remit, may help some patients.