Persistent genital arousal disorder (PGAD) is a rare condition that involves experiencing unwanted sensations of arousal in your genitals that don’t resolve with one or more orgasms. Left untreated, PGAD can take a toll on your body and mental health and reduce your quality of life. Don’t be embarrassed to reach out to your healthcare provider for help.
Persistent genital arousal disorder (PGAD) involves experiencing unpredictable, uncontrollable physical sensations associated with sexual arousal — but in the absence of desire. Sexual arousal is usually associated with pleasure, but this isn’t the case with PGAD. With PGAD, you experience arousal as unwanted physical sensations in your genitals. You can’t control when these changes begin, and orgasm doesn’t relieve them.
Instead of making you feel sexual, PGAD may lead to feelings of frustration and embarrassment. It may even be debilitating without help from a healthcare provider.
PGAD wasn’t identified until 2001, and it’s not a common diagnosis. For this reason, researchers are still learning its causes and what treatments work best.
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The researchers who identified PGAD in 2001, Leiblum and Nathan, originally called it persistent sexual arousal syndrome (PSAS). The word “genital” replaced “sexual” because sexual implies desire, which doesn’t apply to PGAD. This is an important difference between PGAD and hypersexuality, or sex addiction.
Hypersexuality involves desiring sex to the point of excess. With PGAD, desire is removed from the physical experience of arousal.
PGAD has mostly been studied in women and people assigned female at birth (AFAB). Recent research suggests that it may also affect men and people assigned male at birth (AMAB). PGAD has been compared to priapism, a condition that involves having an unwanted erection for four hours or more.
It’s extremely rare. Researchers suggest that it may affect about 1% of people AFAB. It’s difficult to know for sure because it’s likely that many people who experience PGAD symptoms are too embarrassed to seek help.
PGAD involves feelings of intense genital arousal associated with increased blood flow and heightened tension in your clitoris, labia, perineum and anus. Symptoms may last for hours or even days and include:
You may experience orgasms that don’t relieve your symptoms, or you may experience momentary relief through an orgasm only to have your symptoms return.
The sensations in your genitals associated with PGAD may be described as:
These sensations persist without relief. PGAD’s toll on your body can interfere with your day-to-day routine, causing stress, anxiety and depression. Since orgasms become associated with feelings of relief from pain instead of pleasurable sexual release, PGAD can keep you from enjoying sex or having a healthy sexual relationship.
PGAD doesn’t feel good in the way that sexual arousal does. Sexual arousal feels good, in part because you desire the physical sensations. Desire is a key part of a healthy sexual response. Also, you can feel comforted that feelings of release and normalcy will follow the physical experience of heightened sexual tension.
PGAD is different in that you lack control over feelings of arousal, and you don’t know when your body will experience relief or return to its baseline.
Researchers don’t know for certain what causes PGAD. A combination of factors likely plays a role. The causes may be related to blood vessels and blood flow, nerves or behavioral health issues. Certain medications may trigger or worsen PGAD.
Studies have shown that PGAD may be associated with:
Stress, anxiety and depression have all been linked to PGAD. Still, it’s unclear how they relate to potential biological factors associated with PGAD.
There are five criteria for a PGAD diagnosis. They include:
There aren’t standard treatments for PGAD. Studies have demonstrated that the following have eased symptoms for some people with persistent genital arousal disorder:
Ultimately, the treatments for PGAD vary on a case-by-case basis. The condition is so new that researchers are still learning about which treatments and coping strategies work best. Your healthcare provider is your best resource for recommending strategies to manage your symptoms or connect you with a specialist, like a sex therapist, who can help.
You can’t prevent PGAD. You can schedule a visit with your healthcare provider to discuss solutions for getting your symptoms under control.
You should seek help from your healthcare provider if you’re experiencing symptoms that keep you from having a healthy sex life or that cause distress. Getting help is especially important with PGAD when the experience of genital arousal can disrupt your life and harm your mental health.
A note from Cleveland Clinic
It may take some time to locate treatments that work best for you once you’re diagnosed with PGAD. Your care may require a collaborative approach that involves your provider and a behavioral health specialist, like a counselor or therapist. The good news is that although this diagnosis is new, more and more people are receiving the care needed to manage symptoms. Don’t let embarrassment prevent you from getting the help you need to cope with PGAD.
Last reviewed by a Cleveland Clinic medical professional on 08/15/2022.
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