Too much of a good thing. It appears she has persistent genital arousal disorder (P G A D)

By Brian Alexander. Listen to the Podcast at How To Sex.

The other day, a few media outlets in the New York region covered the story of a woman who can’t seem to stop having orgasms, which would seem joke-ready but can actually be a nightmare.

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Doctor Brian Alexander files this assessment;

While the New Jersey woman’s condition has not been formally diagnosed, it appears she has persistent genital arousal disorder (P G A D), something we explored years ago. 

The syndrome usually manifests as a constant blood engorgement of the female genitals, mainly the clitoris. This creates a sensation of needing “relief.” Cue the jokes. But imagine constantly sensing the need for orgasm at work, on the bus, while visiting with friends, and then finding no relief, or only very temporary relief, if you masturbate. Genitals can become highly sensitive, and sore. Sufferers describe feelings of isolation and mental anguish.

Unfortunately, nobody is quite sure what causes it or how to treat it, but, according to Jim Pfaus, a researcher at Montreal’s Concordia University who studies the neuroscience of sexual response, and who is currently engaged in studying persistent genital arousal, there are enough clues to develop a working theory.

“The root cause,” he explained, “may be an irritation of the clitoral sensory nerves.” The brain interprets this sensation and sets off a cascade of events.

If you want to incur the rage of a woman in this condition, even the slightest suggestion comparing her to a nymphomaniac, could result in you likely getting beaten up and humiliated.

 She didn’t ask for this, and she detests its imposition almost as much as sexual assault. A woman wants to be a willing participant. Offer her whatever help she asks for, but it may be for you to get the hell out of here, especially if she usually has some attraction to you, and is now confused by her physically-aroused state.

A brain region called the pro-optic area responds to dopamine signaling by sending out instructions for the body to prepare for sex, as if a woman has been engaged in foreplay when, in fact, she’s not remotely in a sexual context. Blood flows to the genitals. “So we think that this blood flow is in a state of hyperarousal in women with P G A D,” Pfaus said. “They get engorgement quickly, reach orgasm quickly when they try to relieve themselves. It shares features with premature ejaculation and priapism” in men.

That’s consistent with observations others have made. For example, Barry Komisaruk at Rutgers University found that of a group of 18 women with P G A D, 12 had cysts on nerves in the sacral region of their spines. The cysts may be stimulating clitoral nerves.

A variety of drug therapies (there’s even one report of a physical therapy involving manipulation of muscles in the region) have shown to help. SSRIs, commonly used for depression, seem to provide some relief. But Pfaus believes the drug varenicline (Chantix, commonly used for smoking cessation) is most promising. It works by interrupting the signaling that leads to dopamine release. Blood stops flowing.

While the therapy has worked in scores of women, Pfaus said, the drug isn’t perfect. “Unfortunately it comes back when they go off it.” 

Brian Alexander

Moon Sprayed Eyes tells us about her condition, and the problems she still faces.

It Killed My Marriage

I haven't received any diagnosis yet, but I have experienced nearly all of these symptoms as far back as preschool.

I have been to so many doctors, Primary Care Managers, Obstitricians, Gynecologists,, and mental health professionals, due to how I describe the sensations of throbbing, tingles; that make me feel like I'm trapped in a constant state of arousal; that is debilitating, deviant-like, impositions.

For 25 out of my 40 years I've not heard anything closely related to P G A D.

However, I have received diagnoses of; hypersexuality, sexual addiction, masturbation addiction, PTSD, hypersensitivity, rejection sensitivity, childhood trauma, divorce anguish, adult trauma, shame, guilt, agoraphobia, Major Depressive Disorder, anxiety.

The fallout?  I was married 11 years. We tried individual and couples therapy 6-7 times and completed all sorts of “activities”, “homework” and received certificates.

It didn’t get better because my spouse husband couldn’t keep up what wasn’t natural to him.

We both had a hand in the demise of our marriage and we both deeply regret not being what the other person needed.

I really hope other marriages can fix or improve the parts that matter most;  because I don’t wish this pain on anyone.

My former husband and I have been grieving each other’s loss since 2021 and I don’t think we’ll ever get over the loss of each other to “move on.” Not because we haven’t tried, but It’s not as easy to start over as one would think, when nothing feels normal. I don’t have the answers but I don’t wish this fate on anyone either.

Well you get the idea. All that just to learn, I was describing Persistant Genital Arousal Disorder 100% accurately, the whole time.

Along with nerve pains, and restless leg, insomnia. but hey, its all in my head, right?. Anyways.

Everything I've read, talk about biases, and that it's considered to be rare; more medical gas-lighting. 🫢

I am very interested to see what else comes out, and I’ll find as many research studies to bring the printed reports to my next appointment, because I can already see him rolling his eyes, and calling the nurse to bring the straightjacket.

Amp It faced a short term crisis with this disorder. She summarizes her ordeal.

My Doctor Needs To Grow Up!

I had P G A D for about a week earlier this year. It was one of the worst things I have ever experienced. I was a hysterical mess after just a few days. I genuinely felt like I was losing my grip on my sanity. Orgasms didn’t even help—they actually made it worse. It hurt and the constant pressure in my pelvis was unbearable. There was a lot of ice packs and lidocaine and sobbing. I can’t imagine dealing with that BS long term. I don’t think I would even survive it. It was hell. Not even remotely sexy.

Since I had back surgery a few months ago my Gynecologist thought it could be something nerve related and wanted me to follow up with my neurosurgeon too. He did order an MRI for me, but the man would not stop cracking jokes at my husband about; “Ha ha ha, just don’t turn her on, am I right?”

No, sir. That was probably my grossest interaction with a doctor.

Glass Breather retells a grim story of her friend’s tortured life and premature death.

It’s Perpetual Rape.

I have a friend who has suffered from this for her whole life, since she was five. She said the only way she could describe it was like being raped by demons constantly. Constant engorgement of the genitals, anxiety and stress would also cause unwanted stimulation which could not be contained through masturbation. It only made it worse. Orgasms would also usually make it worse.

Many of the women who suffer from this end up committing suicide. She has managed through a rigorous daily routine of yoga and meditation.

There are some theories that it has something to do with the psoas muscle, near the tailbone; or some sort of impinged spinal nerve that sends a feedback loop to the brain.

It is so far from pleasurable. Torture is closer to the truth.

Love In The Sun gives us a clinical insight.

The desperation leads to bold behavior

I worked as a nurse in a big gynecology clinic. This was a teaching hospital in the US. We had a doctor who specialized in it.

Yes the suffering women would start masturbating in front of the doctor and would masturbate many many times a day, to the detriment of their lives.

She couldn’t hold a job, be a parent, or much of anything besides just being perpetually frustrated.

It was absolutely heartbreaking to hear their stories.

So no, this isn’t the same pleasurable experience most of us experience as an orgasm. It’s not pleasurable at all.

Widespread

The condition is profound and widespread, but most sufferers are terrified that they might become exposed to public embarrassment and mockery.

LOS Angeles concert-goers were enjoying a rendition of Tchaikovsky's fifth symphony last week, when the sound of someone having a 'loud and fully body orgasm' suddenly cut through the music.

The incident sparked lively debate between audience members about whether the moaning woman was in the throes of toe-curling pleasure, or if she jerked awake after nodding off and having a bad dream.

Spectator Molly Grant told the LA Times she thought the unknown woman had orgasmed; "because she was heavily breathing, and her partner was smiling and looking at her, like in an effort to not shame her."

But another attendee said they'd witnessed her fall asleep on her partner's lap and wake with a cry 'five seconds later'.

Nevertheless, her 'scream/moan', which the LA Philharmonic blithely continued playing over, lead some to wonder whether the woman was suffering from a rare condition which causes uncontainable genital arousal.

Known as persistent genital arousal disorder, sufferers can feel aroused without experiencing sexual desire and many can have multiple unprovoked orgasms over hours, days or weeks.

Researchers estimated it may affect one per cent of the population, although not everyone's symptoms can are as severe.

Being constantly aroused however, isn't as fun as it sounds.

Medical News Today reported that people with P G A D can have trouble getting on with their day-to-day lives and may experience anxiety, panic attacks and depression.

Christine Decker from Wisconsin, developed the ultra rare condition after slipping a disk in her back.

She suffered a terrifying 236 orgasms in hospital while paramedics watched in horror, and Christine later became completely housebound.

When she spoke up about experiencing more than 100 orgasms daily, she was met with merciless trolling rather than sympathy.

Christine said the hormone therapy which reduced her levels of testosterone also slashed the number of her daily orgasms to just eight.

For mum Cara Anaya-Carlis, having P G A D meant something as simple as the vibrations from a washing machine could send her spiraling into episodes that could last between four and six hours, where she'd experience orgasms every 30 seconds.

Cara began to 'feel too dirty' to be a part of her son's life and felt too embarrassed to work.

Lior Ofir Schwartz from Miami Beach, Florida; began feeling constantly aroused despite not having sexual desires in 2012.

She described the feeling as a 'painful' itch she could not scratch, which would usually come on before the orgasms, when she was stressed, or at night.

Lior's condition worsened to the point that she was unable to have sex with her now husband Jonathan, when she began dating him, due to the pain.

And a mum in England, who started suffering uncontrollable orgasms following an NHS checkup, was left devastated after being told her health board wouldn't fund the medicinal cannabis to help her.

The widow, from East Dunbartonshire, told the The Herald: “Why should I be paying the bill when I didn’t cause the problem? This was inflicted on me by the NHS, so the NHS should be paying for it.

"It’s been recommended by the very specialist they sent me to – that I had to fight to be sent to – and now they’re ignoring his advice.

"The condition has calmed down a lot. My own GP says she’s never seen me looking better in the past two years than I do now. They’re the only thing that’s worked. For me, it’s amazing not to have feeling down there."

Maria believes the condition was sparked during a routine check at Glasgow's Stobhill Hospital in September 2017, claiming a consultant "rammed" a speculum into her.

In the weeks after the examination, Maria said she started to notice distressing symptoms, which were eventually diagnosed as P G A D, caused by damage to her pudendal nerve.

And she said she was furious after it was a NHS consultant who recommended the treatment, with the board now not paying.

Thar She Blows

Lorna, who runs a food delivery service, drove over a speed bump in January 2019.

She said: “I felt a pounding and bulging sensation below.

“It was lucky I didn’t crash as I was losing control of my body.

“When I got to the house, I handed over the lunch with my legs crossed, ran to the car and quickly drove home.”

When it recurred, she saw her GP last July.

They offered an epilepsy treatment that eases nerve pain, and reduces the length of episodes.

Lorna, of Doncaster, South Yorks, turned down an ultrasound fearing it would send her into throes of orgasm, but never followed by a pleasant afterglow.

She added: “Once in a supermarket I had to grab shelves for support.

“People looked at me strangely. Another time my friend simply mentioned my boyfriend. I began panicking.

“I’d already started orgasming and so I ran inside a shop.”

She said of her love life: “Henry found it funny at first, but now we can’t kiss passionately as it sets me off. He counts down from three then says: ‘Thar she blows!’

Bewildered Doctors

Doctors have struggled to identify what exactly causes P G A D.

According to Medical News Today:

·         stress,

·         Tourette's syndrome,

·         epilepsy,

·         trauma to the central nervous system and

·         surgery to the lower back

could trigger the condition.

In a 2012 study, MRI results showed that 66.7 per cent of women who demonstrate P G A D symptoms also had a Tarlov cyst - abnormal sacs filled with spinal fluid in the base of the spine.

PERSISTENT genital arousal disorder (P G A D) is spontaneous, persistent and unwanted genital arousal without any sexual desire or satisfaction.

Multiple orgasms over hours, days or weeks can be agonising for sufferers, offering no relief.

Scientists do not know what causes the condition, but suspect neurological, vascular, pharmacological or psychological causes may play a role.

Symptoms can persist for long periods of time, and include:

• pressure
• pain
• clitoral throbbing
• tingling
• vaginal congestion
• vaginal contractions
• spontaneous orgasms

The signs and symptoms can affect the vagina, labia, perineum and anus.

The condition can impact on a sufferer's work and home life, leaving many feeling embarrassed, and avoiding sexual relationships.

People who have P G A D can undergo cognitive behavioral therapy, to help identify what triggers the attacks, and to manage the ensuing anxiety.

Antidepressants and anti-seizure drugs have also been used as treatment, and - in the case of Tarlov cysts being presence, surgery could also work.

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