Q. What is persistent genital arousal disorder, and how can it be treated?

A. Persistent genital arousal disorder is an unrelenting, unwanted, intrusive, and spontaneous s.e.xual sensation.

It manifests as pressure or discomfort, often engorgement, pulsating, pounding and/or throbbing in the genital tissues such as the clitoris, labia, vagina and/or in the perineum and/or anus in the absence of conscious thoughts of s.e.xual desire or s.e.xual interest.

Little is known about the cause. It is associated with spontaneous orgasms or a feeling that orgasm is imminent or that orgasmic release is needed to reduce the feelings of persistent arousal, but where symptoms are not consistently diminished by orgasmic release.

ANTIDEPRESSANTS

Persistent genital arousal disorder is often associated with significant personal worry and distress. Many women who experience this arousal disorder are ashamed and shamed for having inappropriate genital feelings.

Persistent genital arousal disorder may be present throughout the person’s life or can develop in later life. It is sometimes a side-effect of certain antidepressants, such as trazodone, or secondary to sudden withdrawal of selective serotonin re-uptake inhibitors.

Hormonal causes may be a symptom of the use or discontinuation of hormone therapy in post-menopausal women, and excess use of herbal oestrogens in over-the-counter agents. Some cases are idiopathic, or of unknown cause.

WHAT TO DO?

Women with the disorder should have a detailed history taken and be physically examined. There should also be laboratory testing.

Careful history taking is needed to document whether the condition is linked to medication. Physical examination may be used to identify potential nerve causes. Blood tests can be used to assess any possible causes linked to hormones or initiation and discontinuation of hormone therapy in post-menopausal women.

ANAESTHETIC

Women with the disorder say stress worsens their symptoms, whereas distraction and relaxation strategies lessen them. Therapeutic options will be guided by how severe the symptoms are and possible causes. Relaxation techniques have assisted some women.

Topical anesthetic agents have also been used. Discontinuing any medicines may be helpful in diagnosis and treatment as may electrical nerve stimulation.

• Dr. Tlaleng Mofokeng (MBChB), s.e.xual and reproductive health practice, Disa Clinic, safersex.co.za.

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