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Recently I saw a patient with an interesting and peculiar complaint: she felt constant clitoral arousal that lead to pressure that she could not relieve. It was leading to anxiety and disrupting her life and activities. Even after achieving orgasm from masturbation, she would still sense the clitoris to be stimulated.
It was fortuitous that I read about this condition about 3 months before I saw the patient in the office. It is a little known condition that was first described in 2001. It is a problem of genital arousal, not sexual arousal. Patients will experience tingling, pressure, irritation, congestion, throbbing, pain or vaginal contractions. Only sometimes can sexual intercourse or masturbating alleviate the sensation. In a recent Dutch study, there appears to be a correlation between PGAD, overactive bladder and anxiety.
In my patient’s case, as is described for PGAD, the patient felt genital/clitoral arousal the entire day; it was unwanted and intrusive to her life; it was triggered by non-sexual activity (she had a UTI that preceded it); it lead to distress; it was not associated with a psychological condition. Because of the problem, her anxiety level is raised which leads to a vicious cycle of worsening the condition.
What are considered to be the triggers for PGAD?
Sexual stimulation
Masturbation
Stress
Anxiety
Loss
Menses
What can exacerbate the condition?
Pressure against the genitals
Visual arousal
Vibration (car, motor)
Stimulation by partner
Intercourse
PMS
Genitals becoming too hot
Riding a bicycle/horse
There is no specific treatment since the cause remains vague. Psychosocial support and defining the condition helps to create some knowledge that such a condition exists. Intercourse or orgasm may bring some temporary relief. Ice or topical anesthetics can help reduce swelling and sensation. Pelvic massage or stretching exercises may help. Mood stabilizing medication is empiric and may or may not help, especially if there is underlying anxiety or depression. Anxiety-reducing coping skills and activities can lead to distraction and may be useful.
Thus far, topical anesthetics have brought my patient some relief.
Add a Comment30 Comments
I have a few comments on this. I have experienced consistent arousal. I dated a man who was very good at giving women oral orgasms. I'd never mastered my clitorus & had an accidental orgass maybe once during sex. He was very good at oral sex. Since then I learned how to masterbated well and have stimulated myself to much. I also think there may be more of a mental component to this then realized.
August 27, 2018 - 6:03pmThis Comment
Hi, i am 21 year old virgin, and i am having irregular periods since 2013, which leads to heavy waist ache whenever there is delay in my periods. I have been to a GYN, and after being examined twice my uterus was normal. Everything was normal, but all i have ia delayed periods, irregularities. Though the doctor says hormonal problems, but i fear infertlity, and seroius disease. I have periods in 4 to 6 months, i do not understand, whether it will affect my health or i can conceive.
September 14, 2014 - 5:00amplease suggest.
This Comment
Your not exactly experiencing the same disorder as the rest of us. Think u should seek drs advice
September 14, 2014 - 7:44amThis Comment
I have struggled with this on and off. I have recently stopped taking the antidepressant Citalopram and would have thought nothing of it except for an earlier post.
I couldn't think about what could have possible triggered this irritating and painful feeling. I have experienced the constant arousal, but it gets worse at night because I have nothing distracting me from it. I am losing a lot of sleep.
While an orgasm helps me fall asleep, I am awake 15 minutes later, with that ache. I have used ice packs which alleviates it for a half hour or so, but who can walk around with an ice pack on their genitals all day.
I am just happy that I found this because I have been searching for answers. I have printed out several articles to take into my nurse practitioner and hopefully I can find some relief.
May 7, 2014 - 2:06amThis Comment
I suffer from this for at least 2 years now. I wish ppl took it more seriously, from family to doctors it's just seen as an almost desire able condition. If a man complains of being constantly aroused even after release, ppl would easily see the negative ways his life would be impacted. Even women would imagine how horrible it must be to not be able to satiate oneself despite constant attempts at release. For some reason, a woman crying out that she is constantly at the mountains peak and never able to descend, is humorous, belittled, and virtually ignored. I have some days thought I'd just want to die if I have to live life ruled by my body w/ no control whatsoever.
April 28, 2014 - 4:40pmThis Comment
Hi everyone. For the past 2 weeks ever since I started taking Adderall I've been consistently aroused. It hasn't went away but does vary in its intensity. I try and ignore it most of the time but if the pressure is too much I try and relieve myself...which only provides a small amount of relief. I am not experiencing orgasims that I don't have to work for; they don't just happen randomly thank you God. It's never been easy for me to orgasim and that hasn't changed. Now I'm smelling within the last day a strange odor. The arousal pressure also feels like I have to urinate, which if I go to the bathroom I do urinate. I also currently began taking Welbutrin within the past 2 months while being weened off Effexor. I work 2 jobs and don't have one to randomly see my doctor. I'm scheduled to see my psychiatrist on the 19th so I'm trying to hold our until then. Please, does this sound familiar to anyone?
March 12, 2014 - 2:51amThis Comment
yes im also having this problem im taking effexor
May 28, 2015 - 7:12pmThis Comment
Update: I went and saw my PCP. The odor is from a bacteria infection that can be treated with antibiotics. Also she took me off the adderall so hopefully that helps with the arousal.
March 12, 2014 - 3:45pmThis Comment
How do you all cope? Im a week in with this and i feel my life is over
November 14, 2013 - 5:34pmAnd i have no hope whatsoever.
This Comment
I have arachnoiditis and this symptom just started a few months ago. It came on gradually, fun at first....now I hate it & want it to go away. It's 24/7 now & to the point of uncomfortable distraction. I also had been getting increased UTI's prior to the onset. It's a nightmare.
June 2, 2012 - 3:45pmThis Comment