Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-study
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...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-12-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-48790-2 |
| _version_ | 1797377077038546944 |
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| author | Franziska M. L. M. Kümpers Christopher Sinke Cordula Schippert Katja Kollewe Sonja Körner Peter Raab Bernhard Meyer Sabine Maschke Matthias Karst Christian Sperling Eleni Dalkeranidis Tillmann H. C. Krüger |
| author_facet | Franziska M. L. M. Kümpers Christopher Sinke Cordula Schippert Katja Kollewe Sonja Körner Peter Raab Bernhard Meyer Sabine Maschke Matthias Karst Christian Sperling Eleni Dalkeranidis Tillmann H. C. Krüger |
| author_sort | Franziska M. L. M. Kümpers |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T19:48:47Z |
| format | Article |
| id | doaj.art-d7180c4af5ea4bbe90ff4f61afec60fb |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-08T19:48:47Z |
| publishDate | 2023-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-d7180c4af5ea4bbe90ff4f61afec60fb2023-12-24T12:14:38ZengNature PortfolioScientific Reports2045-23222023-12-0113111610.1038/s41598-023-48790-2Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-studyFranziska M. L. M. Kümpers0Christopher Sinke1Cordula Schippert2Katja Kollewe3Sonja Körner4Peter Raab5Bernhard Meyer6Sabine Maschke7Matthias Karst8Christian Sperling9Eleni Dalkeranidis10Tillmann H. C. Krüger11Divison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical SchoolDivison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical SchoolDepartment of Obstetrics and Gynaecology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolDepartment of Diagnostic and Interventional Neuroradiology, Hannover Medical SchoolDepartment of Diagnostic and Interventional Radiology, Hannover Medical SchoolDepartment of Diagnostic and Interventional Radiology, Hannover Medical SchoolDepartment of Anaesthesiology, Pain Clinic, Hannover Medical SchoolDivison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical SchoolDivison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical SchoolDivison of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical SchoolAbstract 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.https://doi.org/10.1038/s41598-023-48790-2 |
| spellingShingle | Franziska M. L. M. Kümpers Christopher Sinke Cordula Schippert Katja Kollewe Sonja Körner Peter Raab Bernhard Meyer Sabine Maschke Matthias Karst Christian Sperling Eleni Dalkeranidis Tillmann H. C. Krüger Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-study Scientific Reports |
| title | Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-study |
| title_full | Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-study |
| title_fullStr | Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-study |
| title_full_unstemmed | Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-study |
| title_short | Clinical characterisation of women with persistent genital arousal disorder: the iPGAD-study |
| title_sort | clinical characterisation of women with persistent genital arousal disorder the ipgad study |
| url | https://doi.org/10.1038/s41598-023-48790-2 |
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