Persistent Genital Arousal Disorder (PGAD)


When faced with such a complicated and ill-understood condition as PGAD, you want to see the best physician possible. The staff at New York Bone and Joint Specialists understands the importance of your treatment and will strive to ensure you receive top quality care at our Upper East Side or Midtown West facilities.



Persistent Genital Arousal Disorder is excessive female arousal that can persist from hours to weeks to the point of physical pain and mental distraction and frustration. With PGAD, you will feel excessive vaginal congestion and physical signs of arousal spontaneously, without feeling any sexual desire. Most often, these feelings are unwanted and intrusive; the condition is debilitating and intrudes upon daily life. Many women find it difficult to concentrate at work or during mundane tasks like driving, and daily situations like riding the train or going grocery shopping become unbearable.

PGDA is a complex condition about which little is known. Though surveys show that the condition is rather uncommon, it has been noted that many cases of persistent genital arousal disorder go unreported due to shame on the part of the sufferer. Because of the pain and intimacy related with the condition, many women are pushed into emotional turmoil, often depression. Since no singular treatment proves effective for every woman with PGDA, it takes time and patience to find possible contributors and solutions.



The physical symptoms of persistent genital arousal disorder is vascocongestion and other effects of sexual arousal in the genital area. These symptoms eventually turn into pain because of the frequency. This can make activities like sexual intercourse or urinating extremely painful as well. Symptoms can become aggravated by very simple triggers, like cell phone vibrations, sitting, or riding in a car.

Sexual desire is not spurred from these physical feelings. The mental effects of the disorder are dire, as PGAD interrupts work, parenting, and other tasks. Women have often lost their jobs due to their inability to quell persistent genital arousal since it makes it difficult to arrive to work and there is a need to relieve symptoms during the work day. Persistent genital arousal disorder is also detrimental to intimate relationships. While a few women may seek a sexual partner to help relieve symptoms of persistent genital arousal disorder, intercourse can become painful. This often keeps couples from sexual acts, which may require couples therapy to overcome.



There is no known cause of PGDA. Any woman can be affected, young or old, pre or post-menopausal. It seems that the condition is an irregularity in nerves of the pelvic region. It has been connected to pudendal nerve entrapment in some cases.

There are some instances of persistent genital arousal that have apparent causes such as taking SSRIs and a pelvic arterial-venous malformation, which requires surgery.



Because PGAD has no apparent cause, no one treatment works for every diagnosed woman. We offer multiple treatment options to our patients to determine which are most effective for each individual. We can also recommend psychologists and professionals to help cope with the emotional aspects, which is often crucial in overcoming the condition. Some of the treatment options offered include:

  • Pelvic Floor Physical Therapy – PGAD may be a product of abnormal nerve function in the pelvic floor. Pelvic floor physical therapy is a very specific type of therapy that can strengthen pelvic floor muscles therefore reducing irritation to the nerves in the pelvic area.
  • Oral Medications, including hormonal modifiers like birth control
  • Ultrasound Guided Nerve Blocks – These are injections done when it seems likely that persistent genital arousal disorder is caused by pudendal nerve entrapment. This is a direct injection that blocks pain signals to the pelvic nerves.
  • Ultrasound Guided Trigger Point Injections to Pelvic Floor Muscles – Trigger point injections help to break up trigger points and improve blood flow to the muscles of the pelvic floor. The anti-inflammatory substance can release tension in tissues and stop compression of pudendal nerves.
  • Ultrasound Guided Botox Injections to the Pelvic Floor – Botox injections to the pelvic floor muscles help to relax the muscles of the pelvic floor and to block pain signals to the brain.



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