Persistent genital arousal disorder (PGAD; Leiblum & Nathan, 2001 ) is characterized by distressing symptoms suggestive of genital arousal in the absence of subjective feelings of arousal. Although awareness of PGAD is growing, there continues to be a lack of systematic research on it. This study characterized an online sample of women with symptoms of persistent genital arousal (PGA) in terms of their symptom characteristics, medical comorbidities, symptom triggers, management strategies, and predictors of distress. Women reported diverse PGA symptoms, with almost half reporting painful symptoms, and most reported very high distress and negative emotions. Further research and awareness of PGA are needed to provide effective care for this population.
Background Persistent genital arousal disorder (PGAD) is characterized by symptoms of distressing physiological sexual arousal (Persistent genital arousal [PGA] symptoms such as genital vasocongestion, sensitivity, or both) that occur in the absence of sexual desire. There continues to be a lack of systematic research on this condition. Little is known about the common medical comorbidities and psychological, sexual, or relationship well-being of individuals who experience PGA symptoms. Aims To compare these biopsychosocial factors in an age-matched sample of women with and without symptoms of PGA. A secondary aim was to examine what symptom factors (associated distress, symptom severity) and cognitive factors (eg, catastrophizing of vulvar sensations) were associated with psychosocial outcomes in women with symptoms of PGA. Methods Age-matched samples of women with (n = 72) and without (n = 72) symptoms of PGA completed a comprehensive online survey. Main Outcome Measures Participants self-reported their medical histories and completed validated measures of psychosocial functioning (depressive and anxiety symptoms, catastrophizing of vulvar sensations, sexual functioning and distress, and relationship functioning). Results Women with symptoms of PGAD reported significantly greater depressive and anxiety symptoms, sexual distress, and suicidal ideation, as well as significantly poorer relationship functioning than women without PGA symptoms. Catastrophizing of vulvar sensations was related to PGA symptom ratings (greater severity, distress) and psychosocial outcomes (greater depression, anxiety, and sexual distress). Clinical Implications The results of this study highlight medical and psychosocial difficulties associated with PGA symptoms, which should be assessed and addressed as essential components of treatment. Strengths & Limitations This study seeks to address the paucity of research on the well-being of women with PGA symptoms by undertaking a comparison of age-matched samples using validated questionnaires. This study is limited by its self-report, cross-sectional design. Conclusion PGA symptoms are associated with significant health and psychological difficulties. These results highlight the need for continued research in this area to improve identification and treatment for this population.
Background Persistent genital arousal disorder (PGAD) is an understudied condition characterized by unwanted physiologic genital arousal in the absence of subjective sexual arousal. Markos and Dinsmore (Int J STD AIDS 2013;24:852–858) theorized that PGAD shares a number of similarities with vulvodynia (unexplained chronic vulvar pain [CVP]), including symptom characteristics and comorbidities. Aim To compare medical histories, symptom characteristics, pain characteristics, and daily functioning among women with persistent genital pain (PGA) (n = 42), painful PGA (n = 37), and CVP (n = 42) symptoms. Methods An online cross-sectional survey was conducted from October 2015 through April 2016. Outcomes Self-report measures of symptoms, diagnosed medical conditions, pain characteristics (McGill Pain Questionnaire), catastrophizing (Pain Catastrophizing Scale), and daily functioning (Functional Status Questionnaire) were collected. Results All 3 groups reported similar medical diagnoses and high frequencies of other chronic pelvic pain conditions. Women in all 3 groups reported comparable ages at symptom onset and timing of symptom expression (ie, constant vs intermittent). Women in the 2 PGA groups reported significantly greater feelings of helplessness than women in the CVP group. Women in the painful PGA and CVP groups endorsed significantly more sensory terms to describe their symptoms compared with women in the PGA group, whereas women in the painful PGA group reported significantly more affective terms to describe their symptoms compared with women in the CVP group. Women in the 2 PGA groups reported that their symptoms interfered significantly with most areas of daily functioning. Clinical Implications Given the similarities between PGA and CVP symptoms, women with PGA may benefit from similar assessment, treatment, and research approaches. Strengths and Limitations Limitations of the present study include its sole use of self-report measures; the presence of PGA or CVP symptoms was not confirmed by clinical assessment. However, the anonymous design of the online survey could have resulted in a larger and more diverse sample. Conclusion The results of this study provide some initial support for the conceptualization of persistent genital arousal as a subtype of genital paresthesias/discomfort. These results also further highlight the negative impact that PGA symptoms have on many domains of daily living and the need for further research on this distressing condition.
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