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Mulroy ME, Jackowich RA, Pukall CF. Examining the Psychometric Properties of the HBI-19 Scale in a Sample of Women with Persistent Genital Arousal Symptoms. JOURNAL OF SEX RESEARCH 2024; 61:603-613. [PMID: 36826430 DOI: 10.1080/00224499.2023.2176423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD) is a highly distressing, yet poorly understood health concern characterized by persistent, unwanted, and unpleasant genital arousal sensations in the absence of psychological arousal and desire. PGAD/GPD symptoms can be reduced by engaging in frequent sexual behaviors, meaning that hypersexual behavior may be present as a feature of PGAD/GPD in some cases. Given this association and the current lack of measures designed for assessment of PGAD/GPD specifically, the present study aimed to investigate the psychometric properties of the Hypersexual Behavior Inventory (HBI-19) in a sample of women with PGAD/GPD symptoms. Specifically, the factor structure of the HBI-19 was explored via Exploratory Factor Analysis (EFA) as well as evaluation of model fit indices and reliability indices (Cronbach's alpha). EFA revealed a two-factor structure for the HBI-19 in the sample of women with PGAD/GPD symptoms, differing from the originally validated three-factor structure. RMSEA as well as TLI values suggested poor fit for all three models examined, including the two-factor model, while SRMR suggested good fit for the two-factor and three-factor model and suggested poor fit for the one-factor models. These findings suggest measurement non-invariance at the configural level and indicate that hypersexual behavior is best understood as a possible feature of PGAD/GPD as opposed to a core element of PGAD/GPD.
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Affiliation(s)
- M E Mulroy
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - R A Jackowich
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - C F Pukall
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
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Kümpers FMLM, Sinke C, Schippert C, Kollewe K, Körner S, Raab P, Meyer B, Maschke S, Karst M, Sperling C, Dalkeranidis E, Krüger THC. Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-study. Sci Rep 2023; 13:22814. [PMID: 38129493 PMCID: PMC10739833 DOI: 10.1038/s41598-023-48790-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
Persistent Genital Arousal Disorder (PGAD) is a rare condition-mostly in women-where patients perceive prolonged genital arousal without any sexual desire or stimulation. Etiopathological considerations reach from peripheral to central issues over local disturbance of the pudendal nerve to neuropathy, psychosocial, and pharmacological theories. Since well controlled clinical studies about PGAD in conjunction with a mental and somatic health status are missing, this study is a detailed clinical investigation of PGAD patients compared to healthy controls. 26 women who fulfilled diagnostic criteria for PGAD were compared to 26 age matched healthy controls. Investigations included comparison of vegetative, gynaecological and sexual history, psychiatric features as well as a (neuro-)radiological, neurophysiological and gynaecological examination. Moreover, a detailed clinical characterisation of PGAD symptoms was performed. PGAD symptoms were mostly characterised as tingling or prickling and were permanently present. In over 80%, PGAD symptoms were located in the clitoris. Almost 70% reported radiations to other regions of the body. Most frequent trigger factors were tight clothes, mental stress, driving a car/bus/bicycle and sexual intercourse. Relieving factors were mainly distraction, relaxation, physical exercise, masturbation and swimming. In group comparisons, PGAD presented with significant higher rates of sexual dysfunctions, spontaneous orgasms, swelling of the genitals, extraordinary lubrication as well as higher rates in depression, agoraphobia, generalized anxiety disorder and lifetime panic disorder. Significantly more PGAD patients were diagnosed with restless legs symptoms. In contrast childhood traumatization, somatization disorder, suicidality, gynaecological as well as neurophysiological examination of the pudendal nerve were not different between the groups. MRI of the brain, pelvis and spinal cord was unsuspicious and incidental findings - including Tarlov cysts or pelvic venous congestion - were equally distributed among the groups. In summary, our study provides a careful characterization of women with PGAD highlighting a serious mental burden, most probably as a consequence of PGAD. With the current set of clinical investigations there was no evidence of a clear causal relationship to a specific clinical finding as it has been previously discussed. Future studies and additional techniques will have to further explore where and how in the peripheral or central nervous systems PGAD develops.
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Affiliation(s)
- Franziska M L M Kümpers
- Divison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Christopher Sinke
- Divison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Cordula Schippert
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
| | - Katja Kollewe
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Sonja Körner
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Peter Raab
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Bernhard Meyer
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Sabine Maschke
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Matthias Karst
- Department of Anaesthesiology, Pain Clinic, Hannover Medical School, Hannover, Germany
| | - Christian Sperling
- Divison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Eleni Dalkeranidis
- Divison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Tillmann H C Krüger
- Divison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
- Center for Systems Neuroscience, Hannover, Germany.
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Üçem S, Buluş E, Erkol G. Persistent Genital Arousal Disorder as an Atypical Presenting Symptom of Central Nervous System Demyelinating Disorder. Neurol India 2023; 71:1270-1271. [PMID: 38174476 DOI: 10.4103/0028-3886.391352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Selen Üçem
- Department of Neurology, School of Medicine, Koç University, Koç University Hospital, Istanbul, Turkey
| | - Eser Buluş
- Department of Neurology, Koç University Hospital, Istanbul, Turkey
| | - Gökhan Erkol
- Department of Neurology, Koç University Hospital, Istanbul, Turkey
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Mooney KM, Mulroy M, Poirier É, Pukall CF. Interpersonal Experiences with Persistent Genital Arousal: Connections between Symptom Disclosure, Partner Responses, and Catastrophizing on Relationship Adjustment and Symptom Severity. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:182-196. [PMID: 37878759 DOI: 10.1080/0092623x.2023.2269931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Increased research attention to interpersonal factors in genitopelvic pain conditions, such as vulvodynia, have led to more comprehensive understanding of couple dynamics in pain, sexual, and relationship outcomes. There has been very little examination of interpersonal factors in Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia (PGAD/GPD), a distressing condition involving persistent sensations of arousal and often pain. The aims of the present study were to examine whether individuals disclose their symptoms to intimate partners and whether interpersonal variables (e.g., partner responses, symptom disclosure, and catastrophizing) are related to relationship adjustment and symptom severity. Seventy-six individuals with symptoms of PGAD/GPD participated in a one-time anonymous online survey. Over three-quarters (85.5%) of the sample disclosed their symptoms to their partners in some way. Greater supportive partner responses and lower symptom catastrophizing were related to better relationship adjustment among participants with PGAD/GPD symptoms. Greater symptom catastrophizing also predicted greater PGAD/GPD symptom severity. Partner responses were not related to PGAD/GPD symptom severity. Although interpersonal factors have been linked to symptom severity in chronic pain and genitopelvic pain conditions, the results of the current study suggest that interpersonal factors may play a slightly different role in PGAD/GPD symptom experiences and in the conceptualization of PGAD/GPD more broadly.
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Affiliation(s)
- Kayla M Mooney
- Department of Psychology, Queen's University, Kingston, Canada
| | - Maeve Mulroy
- Department of Psychology, Queen's University, Kingston, Canada
| | - Évéline Poirier
- Department of Psychology, Queen's University, Kingston, Canada
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Qiu Q, Chen J, Xu N, Zhou X, Ye C, Liu M, Liu Z. Effects of autonomic nervous system disorders on male infertility. Front Neurol 2023; 14:1277795. [PMID: 38125834 PMCID: PMC10731586 DOI: 10.3389/fneur.2023.1277795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/29/2023] [Indexed: 12/23/2023] Open
Abstract
The male reproductive functions are largely regulated by the autonomic nervous system. Male sexual behavior and fertility primarily depend on the normal function of the higher neural centers related to the autonomic nervous system, the hypothalamic-pituitary-gonadal axis, the autonomic nervous components within the spinal cord and spinal nerves, and certain somatic nerves in the pelvic floor. In this review article, we will summarize the role of the autonomic nervous system in regulating male reproductive capabilities and fertility, its impact on male infertility under abnormal conditions, including the role of drug-induced autonomic nervous dysfunctions on male infertility. The main purpose of this article was to provide an overview of the effects of autonomic nervous dysfunction on male reproductive function and shed light on the potential therapeutic target for male infertility.
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Affiliation(s)
- Qixiang Qiu
- Center for Molecular Pathology, The First Affiliated Hospital, Gannan Medical University, Ganzhou, Jiangxi, China
- Department of Basic Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jincong Chen
- Center for Reproductive Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Nengquan Xu
- Department of Basic Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Xiaolong Zhou
- Department of Basic Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Chenlian Ye
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Min Liu
- Center for Reproductive Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Zhaoxia Liu
- Center for Reproductive Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
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Imgart H, Zanko A, Lorek S, Schlichterle PS, Zeiler M. Exploring the link between eating disorders and persistent genital arousal disorder/genito-pelvic dysesthesia: first description and a systematic review of the literature. J Eat Disord 2022; 10:159. [PMID: 36357896 PMCID: PMC9650894 DOI: 10.1186/s40337-022-00687-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/10/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD) characterized by recurrent physiological genital without corresponding psychological arousal is a poorly understood and researched condition. Based on the first two case descriptions of eating disorders directly linked to PGAD/GPD the aim of this paper was to systematically review the literature on possible associations between eating disorders and PGAD/GPD. METHOD A systematic literature search on eating disorders and PGAD/GPD was conducted in PubMed, PsycINFO, and Scopus, complemented by Google Scholar. We included case reports, case series, cross-sectional studies and review articles published in peer-reviewed journals written in English or German-language. RESULTS The included original papers described a total of 2078 cases with PGAD/GPD symptomatology. Of these, 892 participants fulfilled all five PGAD/GPD core criteria. The aetiology of PGAD/GPD is unknown. Multifactorial genesis of PGAD/GPD is presumed including neurological, pharmacological, hormonal, vascular and psychological causes. A high degree of psychological comorbidity is reported. No study was found that drew a direct link between eating disorders and PGAD/GPD. Although PGAD/GPD symptoms also occur in adolescents, there are no findings in this regard. However, we found a gap in data collection: eating disorders as potential psychiatric comorbidities were systematically recorded in only a few studies. CONCLUSION The existing literature have not yet considered a possible link between eating disorders and PGAD/GPD so far. According to the authors' knowledge, this work is the first review to systematically explore the associations. We suspect underreporting of PGAD/GPD cases in eating disorders and particularly during adolescence. We argue that there are several common factors that appear to be important in the etiology, course, and treatment of both disorders (e.g. hormonal dysregulation or sensory sensitivity and avoidance), warranting future research on the possible comorbidity of these disorders.
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Affiliation(s)
- Hartmut Imgart
- Competence Center for Eating Disorders, Parkland Clinic, Im Kreuzfeld 6, 34537, Bad Wildungen, Germany.
| | - Annika Zanko
- Competence Center for Eating Disorders, Parkland Clinic, Im Kreuzfeld 6, 34537, Bad Wildungen, Germany
| | - Sandra Lorek
- Competence Center for Eating Disorders, Parkland Clinic, Im Kreuzfeld 6, 34537, Bad Wildungen, Germany
| | - Patti-Sue Schlichterle
- Competence Center for Eating Disorders, Parkland Clinic, Im Kreuzfeld 6, 34537, Bad Wildungen, Germany
| | - Michael Zeiler
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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Martín-Vivar M, Villena-Moya A, Mestre-Bach G, Hurtado-Murillo F, Chiclana-Actis C. Treatments for Persistent Genital Arousal Disorder in Women: A Scoping Review. J Sex Med 2022; 19:961-974. [PMID: 35396171 DOI: 10.1016/j.jsxm.2022.03.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 02/23/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Persistent genital arousal disorder (PGAD) is characterized by elevated discomfort associated with persistent genital arousal in the absence of sexual desire. AIM To perform a scoping review of the proposed treatments for PGAD and their efficacy. METHODS A scoping review was carried out (PRISMA-Scr) that included articles on PGAD as the main disorder, only in women, which explained, in detail, the treatment and its efficacy, was empirical, was written in English and Spanish. No prior filtering by years was performed. OUTCOMES Three different effective treatments were found (Physical therapies, pharmacological therapies, and psychotherapeutics in combination with other therapies). RESULTS Thirty-eight articles were selected. From physical therapies, treatments using neuromodulation, transcutaneous electrical stimulation, Botox, surgery, electroconvulsive therapy, manual therapy, pelvic floor therapy, dietary changes, and transcranial magnetic stimulation showed effectiveness. Using the pharmacological approach, paroxetine, duloxetine, pramipexole, ropinirole, and clonazepam treatments were effective. Psychotherapy treatments showed effectiveness only in combination with other types of treatments, specifically a combination of cognitive-behavioral strategies with pharmacological treatment. CLINICAL IMPLICATIONS Pharmacological treatment, specifically SSRIs, have proven to be the therapy of choice for different subtypes of patients. STRENGTHS AND LIMITATIONS This study analyzed treatment effectiveness with different approaches and took into consideration those articles where psychotherapy was used as a combination treatment with pharmacological and physical therapy. The main limitation is that it was focused exclusively on women, and the results cannot be generalized to include men. CONCLUSIONS To date, a combination of pharmacological interventions with physical therapy and, in some occasions, with psychological therapy is main strategy followed to accomplish effective treatment of PGAD. Martín-Vivar M, Villena-Moya A, Mestre-Bach G, et al. Treatments for Persistent Genital Arousal Disorder in Women: A Scoping Review. J Sex Med 2022;19:961-974.
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Affiliation(s)
- María Martín-Vivar
- Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, Madrid, Spain; Universidad Francisco de Vitoria, Madrid, Spain
| | | | | | - Felipe Hurtado-Murillo
- Doctor Peset University Hospital, Center for Sexual and Reproductive Health, Valencia, Spain
| | - Carlos Chiclana-Actis
- Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, Madrid, Spain; Universidad Internacional de la Rioja, La Rioja, Spain; University CEU San Pablo, Madrid, Spain
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Mooney KM, Poirier É, Pukall CF. Persistent Genital Arousal in Relationships: A Comparison of Relationship, Sexual, and Psychological Well-Being. J Sex Med 2022; 19:234-248. [PMID: 34903472 DOI: 10.1016/j.jsxm.2021.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/04/2021] [Accepted: 10/15/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia (PGAD/GPD) is characterized by sensations of physiological genital sexual arousal (and/or other types of genitopelvic dysesthesia) that occur in the absence of subjective feelings of sexual desire. AIMS The aim of this study was to compare relationship, sexual, and psychological well-being in partnered individuals with and without distressing symptoms of PGAD/GPD. METHODS The sample (N = 65 individuals with vulvas and vaginas, N = 11 individuals with penises) of 152 partnered individuals (N = 76 with and 76 without PGAD/GPD symptoms) participated in a one-time anonymous online survey. OUTCOMES The questionnaires assessed relationship satisfaction (Couple Satisfaction Index-Short Form, CSI); sexual satisfaction (Global Measure of Sexual Satisfaction, GMSEX); sexual functioning (Female Sexual Functioning Index, FSFI, or International Index of Erectile Functioning, IIEF); sexual distress (Sexual Distress Scale, SDS); and psychological well-being, as determined by the presence of depression and/or anxiety symptoms (Hospital Anxiety and Depression Scale, HADS). RESULTS Among individuals with vulvas and vaginas, those with PGAD/GPD symptoms reported significantly lower relationship and sexual satisfaction, greater sexual distress, and more symptoms of depression and anxiety than their counterparts in the control group. In addition, these individuals with PGAD/GPD symptoms also reported significantly worse sexual functioning (arousal, orgasm, satisfaction, and pain), and they were significantly more distressed about each aspect of their sexual functioning difficulties compared to those in the control group. Among the small sample of individuals with penises (N = 11), descriptive analyses revealed that total sexual functioning scores did not differ across the PGAD/GPD symptom and control groups. In addition, 64.5% of the total sample with PGAD/GPD symptoms managed unwanted genital arousal by avoiding sex with their partner, while 55.3% managed their symptoms by having sex with their partner, and some individuals with PGAD/GPD used both strategies. CLINICAL IMPLICATIONS The finding that PGAD/GPD symptoms impact relationships indicates that treatment for PGAD/GPD should include consideration of the well-being of one's intimate relationship(s). STRENGTHS & LIMITATIONS This study added to the small literature on experiences of PGAD/GPD in relationships, and it was the first to assess sexual satisfaction. Limitations include the small sample of individuals with penises, and the cross-sectional, correlational design, which does not allow for causal conclusions to be drawn. CONCLUSION Results emphasize the importance of continued research of this population (and their partners) in order to improve diagnosis, intervention, and recognition within the medical community. Mooney KM, Poirier É, Pukall CF., Persistent Genital Arousal in Relationships: A Comparison of Relationship, Sexual, and Psychological Well-Being. J Sex Med 2022;19:234-248.
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Affiliation(s)
- Kayla M Mooney
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Évéline Poirier
- Department of Psychology, Queen's University, Kingston, ON, Canada
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Pease ER, Ziegelmann M, Vencill JA, Kok SN, Collins CS, Betcher HK. Persistent Genital Arousal Disorder (PGAD): A Clinical Review and Case Series in Support of Multidisciplinary Management. Sex Med Rev 2021; 10:53-70. [PMID: 34362711 DOI: 10.1016/j.sxmr.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Persistent genital arousal disorder (PGAD) is an uncommon condition resulting in intrusive, unwanted and distressing symptoms of genital arousal. Presentation can vary and most cases do not have an immediately identifiable etiology. OBJECTIVES To present evaluation and treatment recommendations for PGAD from a multidisciplinary perspective and provide case examples. METHODS A focused review of the literature on diagnosis, workup, and treatment of PGAD was completed. A case series of 3 varying presentations of PGAD is offered. RESULTS PGAD results in high levels of patient distress and is best managed with a multidisciplinary treatment approach. Identification and management of co-occurring symptoms or disease states is imperative, particularly psychologic and psychiatric comorbidities. With appropriate intervention, patients may achieve improvement of their physical symptoms and a decrease in associated psychological distress. CONCLUSION PGAD is an uncommon and highly distressing condition that requires thoughtful evaluation for appropriate diagnosis and treatment. Multidisciplinary treatment approaches provide the best opportunity to address the needs of patients and optimizing treatment response. Pease ER, Ziegelmann M, Vencill JA, et al. Persistent Genital Arousal Disorder (PGAD): A Clinical Review and Case Series in Support of Multidisciplinary Management. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Eric R Pease
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Jennifer A Vencill
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Susan N Kok
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - C Scott Collins
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Hannah K Betcher
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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International Society for the Study of Women's Sexual Health (ISSWSH) Review of Epidemiology and Pathophysiology, and a Consensus Nomenclature and Process of Care for the Management of Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD). J Sex Med 2021; 18:665-697. [PMID: 33612417 DOI: 10.1016/j.jsxm.2021.01.172] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/24/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Persistent genital arousal disorder (PGAD), a condition of unwanted, unremitting sensations of genital arousal, is associated with a significant, negative psychosocial impact that may include emotional lability, catastrophization, and suicidal ideation. Despite being first reported in 2001, PGAD remains poorly understood. AIM To characterize this complex condition more accurately, review the epidemiology and pathophysiology, and provide new nomenclature and guidance for evidence-based management. METHODS A panel of experts reviewed pertinent literature, discussed research and clinical experience, and used a modified Delphi method to reach consensus concerning nomenclature, etiology, and associated factors. Levels of evidence and grades of recommendation were assigned for diagnosis and treatment. OUTCOMES The nomenclature of PGAD was broadened to include genito-pelvic dysesthesia (GPD), and a new biopsychosocial diagnostic and treatment algorithm for PGAD/GPD was developed. RESULTS The panel recognized that the term PGAD does not fully characterize the constellation of GPD symptoms experienced by patients. Therefore, the more inclusive term PGAD/GPD was adopted, which maintains the primacy of the distressing arousal symptoms and acknowledges associated bothersome GPD. While there are diverse biopsychosocial contributors, there is a common underlying neurologic basis attributable to spontaneous intense activity of the genito-pelvic region represented in the somatosensory cortex and its projections. A process of care diagnostic and treatment strategy was developed to guide the clinician, whenever possible, by localizing the symptoms as originating in any of five regions: (i) end organ, (ii) pelvis/perineum, (iii) cauda equina, (iv) spinal cord, and (v) brain. Psychological treatment strategies were considered critical and should be performed in conjunction with medical strategies. Pharmaceutical interventions may be used based on their site and mechanism of action to reduce patients' symptoms and the associated bother and distress. CLINICAL IMPLICATIONS The process of care for PGAD/GPD uses a personalized, biopsychosocial approach for diagnosis and treatment. STRENGTHS AND LIMITATIONS Strengths and Limitations: Strengths include characterization of the condition by consensus, analysis, and recommendation of a new nomenclature and a rational basis for diagnosis and treatment. Future investigations into etiology and treatment outcomes are recommended. The main limitations are the dearth of knowledge concerning this condition and that the current literature consists primarily of case reports and expert opinion. CONCLUSION We provide, for the first time, an expert consensus review of the epidemiology and pathophysiology and the development of a new nomenclature and rational algorithm for management of this extremely distressing sexual health condition that may be more prevalent than previously recognized. Goldstein I, Komisaruk BR, Pukall CF, et al. International Society for the Study of Women's Sexual Health (ISSWSH) Review of Epidemiology and Pathophysiology, and a Consensus Nomenclature and Process of Care for the Management of Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD). J Sex Med 2021;18:665-697.
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Abstract
PURPOSE OF REVIEW The increased identification of seizures with insular ictal onset, promoted by the international development of stereo-electroencephalography (SEEG), has led to the recent description of larger cohorts of patients with insular or insulo-opercular epilepsies than those previously available. These new series have consolidated and extended our knowledge of the rich ictal semiology and diverse anatomo-clinical correlations that characterized insular seizures. In parallel, some experiences have been gained in the surgical treatment of insular epilepsies using minimal invasive procedures. RECENT FINDINGS The large majority of patients present with auras (mostly somatosensory and laryngeal) and motor signs (predominantly elementary and orofacial), an underlying focal cortical dysplasia, and an excellent postoperative seizure outcome. Many other subjective and objective ictal signs, known to occur in other forms of epilepsies, are also observed and clustered in five patterns, reflecting the functional anatomy of the insula and its overlying opercula, as well as preferential propagation pathways to frontal or temporal brain regions. A nocturnal predominance of seizure is frequently reported, whereas secondary generalization is infrequent. Some rare ictal signs are highly suggestive of an insular origin, including somatic pain, reflex seizures, choking spells, and vomiting. Minimal invasive surgical techniques have been applied to the treatment of insular epilepsies, including Magnetic Resonance Imaging-guided laser ablation (laser interstitial thermal therapy (LITT)), radiofrequency thermocoagulation (RFTC), gamma knife radiosurgery, and responsive neurostimulation. Rates of seizure freedom (about 50%) appear lower than that reported with open-surgery (about 80%) with yet a significant proportion of transient neurological deficit for LITT and RFTC. SUMMARY Significant progress has been made in the identification and surgical treatment of insular and insulo-opercular epilepsies, including more precise anatomo-clinical correlations to optimally plan SEEG investigations, and experience in using minimal invasive surgery to reduce peri-operative morbidity.
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Dèttore D, Pagnini G. Persistent Genital Arousal Disorder: A Study on an Italian Group of Female University Students. JOURNAL OF SEX & MARITAL THERAPY 2020; 47:60-79. [PMID: 32762421 DOI: 10.1080/0092623x.2020.1804022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There are very few studies in literature about Persistent Genital Arousal Disorder (PGAD) prevalence to date, and no one has ever been done in Italy. This study replicated the earlier Canadian research in order to investigate the prevalence of PGAD diagnostic criteria in an Italian group of 679 female university students and to compare the results with those obtained in the Canadian group. In addition, the research aimed at verifying if the type or number of PGAD criteria met and the intensity of symptoms are associated with more negative emotions, and if they can be related to age and sexual orientation. The results confirm that some women can experience spontaneous genital sensations that can vary in intensity and duration, and can be associated with a wide range of emotions. However, the results seem to suggest the importance of other factors in the evaluation of the symptoms, rather than factors related to their nature and intensity or age and sexual orientation. Moreover, 2 participants (0.29%) met all five criteria and reported high distress, confirming that there is a potential clinical condition called PGAD, in which the hypertrophic, intense and intrusive spontaneous genital arousal might determine the presence of extremely negative emotions.
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Affiliation(s)
- Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
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Abstract
Abstract
Purpose of Review
Persistent genital arousal disorder (PGAD) is a rare, yet debilitating, disease, which was first described at the beginning of this century and has not yet been considered by the ICD-10 or DSM-5. Since affected subjects usually suffer tremendously, this review aims at offering an overview of pharmacological approaches to treat this disorder.
Recent Findings
Until now, no randomised placebo-controlled clinical trials have been conducted on PGAD, and the international registries have not recorded any ongoing trials. Current knowledge on pharmacological options for the treatment of PGAD relies mainly on case reports/case series. Most importantly, there is evidence that some drugs such as SSRIs and SNRIs might induce or worsen PGAD.
Summary
Knowledge on pharmacological treatment options for PGAD is not yet evidence-based, while some reports even assume an induction of PGAD by serotonergic antidepressants. Nevertheless, practitioners should be aware of PGAD and carefully discuss with the patient an individual treatment trial by considering the experience up to now.
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Calabrò RS, Cacciola A, Bruschetta D, Milardi D, Quattrini F, Sciarrone F, la Rosa G, Bramanti P, Anastasi G. Neuroanatomy and function of human sexual behavior: A neglected or unknown issue? Brain Behav 2019; 9:e01389. [PMID: 31568703 PMCID: PMC6908863 DOI: 10.1002/brb3.1389] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/03/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Sexual desire, arousal, and orgasm are mediated by complex, yet still not fully understood, interactions of the somatic and autonomic nervous systems operating at the central and peripheral levels. Disruption of endocrine, neural, or vascular response, caused by aging, medical illness, neurological diseases, surgery, or drugs, can lead to sexual dysfunctions, thus significantly affecting patients' quality of life. PURPOSE This narrative review aims at characterizing the involvement of the central nervous system in human sexual behavior. METHODS A literature search was conducted using PubMed in its entirety up to June 2018, analyzing the studies dealing with the neurobiological and neurophysiological basis of human sexuality. RESULTS Sexual behavior is regulated by both subcortical structures, such as the hypothalamus, brainstem, and spinal cord, and several cortical brain areas acting as an orchestra to finely adjust this primitive, complex, and versatile behavior. At the central level, dopaminergic and serotonergic systems appear to play a significant role in various factors of sexual response, although adrenergic, cholinergic, and other neuropeptide transmitter systems may contribute as well. CONCLUSIONS Providing healthcare professionals with information concerning sexual behavior may overcome useless and sometimes dangerous barriers and improve patient management, since sexual well-being is considered one of the most important aspects of one's quality of life.
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Affiliation(s)
| | | | - Daniele Bruschetta
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.,Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | | | | | | | - Giuseppe Anastasi
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
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Pukall CF, Jackowich R, Mooney K, Chamberlain SM. Genital Sensations in Persistent Genital Arousal Disorder: A Case for an Overarching Nosology of Genitopelvic Dysesthesias? Sex Med Rev 2019; 7:2-12. [DOI: 10.1016/j.sxmr.2018.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/24/2018] [Accepted: 08/05/2018] [Indexed: 12/14/2022]
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Kruger TH. Can pharmacotherapy help persistent genital arousal disorder? Expert Opin Pharmacother 2018; 19:1705-1709. [DOI: 10.1080/14656566.2018.1525359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Tillmann H.C. Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
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Levin RJ, Both S, Georgiadis J, Kukkonen T, Park K, Yang CC. The Physiology of Female Sexual Function and the Pathophysiology of Female Sexual Dysfunction (Committee 13A). J Sex Med 2017; 13:733-59. [PMID: 27114190 DOI: 10.1016/j.jsxm.2016.02.172] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The article consists of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, and the pathophysiology of female sexual dysfunction but excluding hormonal aspects. AIM To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations according to the Oxford Centre for evidence based medicine (2009) "levels of evidence" wherever relevant. CONCLUSION Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.
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Affiliation(s)
- Roy J Levin
- Reader in Physiology (Retired), Department of Biomedical Science, University of Sheffield, Sheffield, UK: Section 2.
| | - Stephanie Both
- Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, The Netherlands: Section 3
| | - Janniko Georgiadis
- Department of Neuroscience, University Medical Center, Groningen, University of Groningen, The Netherlands: Section 4
| | - Tuuli Kukkonen
- College of Social and Applied Human Science, University of Guelph, Guelph, ON, Canada: Section 6
| | - Kwangsung Park
- Department of Urology, Chonnan National University Medical School, Gwangju, Korea: Section 5
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, WA, USA: Section 1
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Yildirim EA, Hacioglu Yıldırım M, Kucukparlak I, Bircan I, Cicek F, Essizoglu A, Karsidag C, Erkiran M. Case Reports of a Mother and Daughter Diagnosed With Persistent Genital Arousal Disorder. JOURNAL OF SEX & MARITAL THERAPY 2017; 43:295-297. [PMID: 27599029 DOI: 10.1080/0092623x.2016.1232324] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Ejder Akgun Yildirim
- a Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Sexual Dysfunctions Clinic , Istanbul , Turkey
| | - Munevver Hacioglu Yıldırım
- a Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Sexual Dysfunctions Clinic , Istanbul , Turkey
| | - Ilker Kucukparlak
- a Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Sexual Dysfunctions Clinic , Istanbul , Turkey
| | - Irmak Bircan
- b Department of Gynecology and Obstetrics , Surp Agop Hospital , Istanbul , Turkey
| | - Funda Cicek
- c Department of Psychiatry , Caycuma State Hospital , Zonguldak , Turkey
| | - Altan Essizoglu
- d Department of Psychiatry , Eskisehir Osmangazi University, Medical Faculty , Eskisehir , Turkey
| | - Cagatay Karsidag
- e Department of General Psychiatry , Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey
| | - Murat Erkiran
- e Department of General Psychiatry , Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey
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Persistent Genital Arousal Disorder: A Review of Its Conceptualizations, Potential Origins, Impact, and Treatment. Sex Med Rev 2016; 4:329-42. [DOI: 10.1016/j.sxmr.2016.06.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 06/17/2016] [Accepted: 06/18/2016] [Indexed: 11/22/2022]
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21
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Persistent genital arousal disorder following selective serotonin reuptake inhibitor cessation. J Clin Psychopharmacol 2015; 35:352-4. [PMID: 25928703 DOI: 10.1097/jcp.0000000000000318] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Georgiadis JR. Functional neuroanatomy of human cortex cerebri in relation to wanting sex and having it. Clin Anat 2015; 28:314-23. [DOI: 10.1002/ca.22528] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 01/27/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Janniko R. Georgiadis
- Department of Neuroscience/Section Anatomy; University Medical Center Groningen (UMCG), University of Groningen; The Netherlands
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Anzellotti F, Franciotti R, Zhuzhuni H, D’Amico A, Thomas A, Onofrj M. Nonepileptic seizures under levetiracetam therapy: a case report of forced normalization process. Neuropsychiatr Dis Treat 2014; 10:959-64. [PMID: 24926197 PMCID: PMC4049430 DOI: 10.2147/ndt.s60089] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Nonepileptic seizures (NES) apparently look like epileptic seizures, but are not associated with ictal electrical discharges in the brain. NES constitute one of the most important differential diagnoses of epilepsy. They have been recognized as a distinctive clinical phenomenon for centuries, and video/electroencephalogram monitoring has allowed clinicians to make near-certain diagnoses. NES are supposedly unrelated to organic brain lesions, and despite the preponderance of a psychiatric/psychological context, they may have an iatrogenic origin. We report a patient with NES precipitated by levetiracetam therapy; in this case, NES was observed during the disappearance of epileptiform discharges from the routine video/electroencephalogram. We discuss the possible mechanisms underlying NES with regard to alternative psychoses associated with the phenomenon of the forced normalization process.
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Affiliation(s)
- Francesca Anzellotti
- Department of Neuroscience and Imaging, Aging Research Centre, Gabriele d’Annunzio University Foundation, Gabriele d’Annunzio University, Chieti, Italy
| | - Raffaella Franciotti
- Department of Neuroscience and Imaging, Aging Research Centre, Gabriele d’Annunzio University Foundation, Gabriele d’Annunzio University, Chieti, Italy
| | - Holta Zhuzhuni
- Department of Neuroscience and Imaging, Aging Research Centre, Gabriele d’Annunzio University Foundation, Gabriele d’Annunzio University, Chieti, Italy
| | - Aurelio D’Amico
- Department of Neuroscience and Imaging, Aging Research Centre, Gabriele d’Annunzio University Foundation, Gabriele d’Annunzio University, Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience and Imaging, Aging Research Centre, Gabriele d’Annunzio University Foundation, Gabriele d’Annunzio University, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience and Imaging, Aging Research Centre, Gabriele d’Annunzio University Foundation, Gabriele d’Annunzio University, Chieti, Italy
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Anzellotti F, Franciotti R, Onofrj M. Temporal recruitment of cortical network involved in reading epilepsy with paroxysmal alexia: a combined EEG/MEG study. Seizure 2013; 22:156-8. [PMID: 23287492 DOI: 10.1016/j.seizure.2012.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 11/15/2012] [Accepted: 11/23/2012] [Indexed: 10/27/2022] Open
Affiliation(s)
- Francesca Anzellotti
- Department of Neuroscience and Imaging, G. d'Annunzio University, Aging Research Centre, Ce.S.I., G. d'Annunzio University Foundation, Chieti, Italy.
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Facelle TM, Sadeghi-Nejad H, Goldmeier D. Persistent genital arousal disorder: characterization, etiology, and management. J Sex Med 2012; 10:439-50. [PMID: 23157369 DOI: 10.1111/j.1743-6109.2012.02990.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Persistent genital arousal disorder (PGAD) is a potentially debilitating disorder of unwanted genital sensation and arousal that is generally spontaneous and unrelenting. Since its first description in 2001, many potential etiologies and management strategies have been suggested. AIM To review the literature on PGAD, identify possible causes of the disorder, and provide approaches to the assessment and treatment of the disorder based on the authors' experience and recent literature. METHODS PubMed searches through July 2012 were conducted to identify articles relevant to persistent sexual arousal syndrome and PGAD. MAIN OUTCOME MEASURES Expert opinion was based on review of the medical literature related to this subject matter. RESULTS PGAD is characterized by persistent sensations of genital arousal in the absence of sexual stimulation or emotion, which are considered unwanted and cause the patient at least moderate distress. The proposed etiologies of PGAD are plentiful and may involve a range of psychologic, pharmacologic, neurologic, and vascular causes. PGAD has been associated with other conditions including overactive bladder and restless leg syndrome. Assessment should include a through history and physical exam and tailored radiologic studies. Treatment should be aimed at reversible causes, whether physiologic or pharmacologic. All patients should be considered for cognitive therapy including mindfullness meditation and acceptance therapy. CONCLUSIONS PGAD likely represents a range of conditions manifesting in unwanted genital sensations. Successful treatment requires a multidisciplinary approach and consideration of all reversible causes as well as cognitive therapy.
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Affiliation(s)
- Thomas M Facelle
- UMDNJ New Jersey Medical School-Surgery-Urology, Newark, NJ 07103, USA.
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Komisaruk BR, Lee H. Prevalence of Sacral Spinal (Tarlov) Cysts in Persistent Genital Arousal Disorder. J Sex Med 2012; 9:2047-56. [DOI: 10.1111/j.1743-6109.2012.02765.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Anzellotti F, Onofrj V, Maruotti V, Ricciardi L, Franciotti R, Bonanni L, Thomas A, Onofrj M. Autoscopic phenomena: case report and review of literature. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2011; 7:2. [PMID: 21219608 PMCID: PMC3032659 DOI: 10.1186/1744-9081-7-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 01/10/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND Autoscopic phenomena are psychic illusory visual experiences consisting of the perception of the image of one's own body or face within space, either from an internal point of view, as in a mirror or from an external point of view. Descriptions based on phenomenological criteria distinguish six types of autoscopic experiences: autoscopic hallucination, he-autoscopy or heautoscopic proper, feeling of a presence, out of body experience, negative and inner forms of autoscopy. METHODS AND RESULTS We report a case of a patient with he-autoscopic seizures. EEG recordings during the autoscopic experience showed a right parietal epileptic focus. This finding confirms the involvement of the temporo-parietal junction in the abnormal body perception during autoscopic phenomena. We discuss and review previous literature on the topic, as different localization of cortical areas are reported suggesting that out of body experience is generated in the right hemisphere while he-autoscopy involves left hemisphere structures.
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Affiliation(s)
- Francesca Anzellotti
- Department of Neuroscience and Imaging, Aging Research Centre, Ce.S.I., "G. d'Annunzio" University Foundation G. d'Annunzio University, Chieti, Italy
| | | | - Valerio Maruotti
- Department of Neuroscience and Imaging, Aging Research Centre, Ce.S.I., "G. d'Annunzio" University Foundation G. d'Annunzio University, Chieti, Italy
| | - Leopoldo Ricciardi
- Department of Neuroscience and Imaging, Aging Research Centre, Ce.S.I., "G. d'Annunzio" University Foundation G. d'Annunzio University, Chieti, Italy
| | - Raffaella Franciotti
- Department of Neuroscience and Imaging, Aging Research Centre, Ce.S.I., "G. d'Annunzio" University Foundation G. d'Annunzio University, Chieti, Italy
| | - Laura Bonanni
- Department of Neuroscience and Imaging, Aging Research Centre, Ce.S.I., "G. d'Annunzio" University Foundation G. d'Annunzio University, Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience and Imaging, Aging Research Centre, Ce.S.I., "G. d'Annunzio" University Foundation G. d'Annunzio University, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience and Imaging, Aging Research Centre, Ce.S.I., "G. d'Annunzio" University Foundation G. d'Annunzio University, Chieti, Italy
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Pereira VM, Silva ACDOE, Nardi AE. Transtorno da excitação genital persistente: uma revisão da literatura. JORNAL BRASILEIRO DE PSIQUIATRIA 2010. [DOI: 10.1590/s0047-20852010000300009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Realizar uma revisão da literatura sobre o transtorno da excitação genital persistente (TEGP), um quadro clínico que acomete somente mulheres, recentemente descrito na literatura, caracterizado por sinais fisiológicos de excitação sexual sem a presença de desejos ou estímulos sexuais. MÉTODOS: Foi realizada revisão sistemática com busca nas bases científicas PubMed, ISI, SciELO e PsycInfo. Do total de artigos encontrados, 27 foram selecionados para integrar esta revisão. RESULTADOS: Os artigos, em sua maioria, são relatos de casos. Apesar de algumas hipóteses diagnósticas terem sido propostas, ainda não existe consenso sobre etiologia, fatores de risco e epidemiologia desse transtorno. A literatura aponta para uma correlação positiva entre a presença do transtorno e quadros depressivos, ansiosos e sintomas obsessivo-compulsivos. CONCLUSÃO: Há necessidade de estudos mais amplos para o melhor entendimento desse quadro clínico. É possível que muitos casos passem despercebidos pelos profissionais de saúde por desconhecimento dos critérios diagnósticos.
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