Persistent genital arousal syndrome is one of the most frustrating syndromes that I’ve faced while practicing at MCFS. Typically, a patient complaining of PGAS symptoms presents to us after some time of suffering. Since this syndrome affects each woman differently, a careful history must be taken. Although more research is being dedicated to this syndrome, standardized treatment protocols do not exist.
Typically, PGAS patients are post menopausal women, however, we have seen patients of all ages. The most common complaint is of a persistent, torturous feeling of arousal in her genitals that is not relieved by orgasm. The arousal is unsolicited and conscious sexual desire or sexual stimulation is absent. Some patients complain that they feel like their clitoris is constantly engorged and throbbing, other patients complain of constant vaginal contractions. Some patients experience both symptoms at the same time. Symptoms typically wax and wane, however, they remain present for most of the day, interfering with their activities of daily living and prevent them from getting restful sleep.
Perhaps the most debilitating aspect of this syndrome is the isolation that our patients experience. They are usually embarrassed by their condition and understandably are afraid to disclose to others what they are experiencing in fear of being misunderstood or mislabeled as sex-crazed nymphomaniacs. Unfortunately, this disorder is also grossly misunderstood by the greater medical community.
A careful history and physical exam must be taken as every woman experiences the symptoms differently. Although there is no definitive treatment, pelvic floor physical therapy can be helpful if there is pudendal nerve entrapment as well as certain medications to help dial down the arousal symptoms. We have been very successful in providing emotional support and a safe place for our patients to express themselves. Online support groups can be very helpful, but some of our patients have reported feeling hopeless after being on them for a long time. Our trained therapists keep our patients focused on hope; our medical providers stay abreast of every published research study and present all treatment options to our patients to help them make an informed decision about their care.
We are hopeful that one day soon PGAS will become a temporary, treatable condition. We are committed to standing by our patients until that time comes.
