Persistent genital arousal disorder: A systematic review

Purpose. - Persistent genital arousal disorder (PGAD) is a newly recognized condition rarely reported. Its recognition is useful to avoid labelling women suffering from PGAD as "mad". Methods. - A comprehensive literature review using Pubmed, Medline, Embase and Cochrane: "persistant genital arousal", "restless genital syndrome", "persitant genital arousal syndrome" and "persistant sexual arousal syndrome". In the 300 articles, 37 really dealt with PGAD. Results. - PGAD prevalence seemed to be more common than suspected (1%). PGAD has officially been defined in terms of five diagnostic criteria. Patients were on average from 35 to 54 years old. Among them, 29.9% to 67% were menopausal. PGAD was highly associated with overactive bladder (OAB) (67%), restless legs syndrome (RLS) (67%) and pelvic varices (55%). Genital sensations were experienced as unwanted, intrusive, on the verge of an orgasm. The unwanted genital sensations were experienced at the clitoris, labia and vagina or a combination of these localizations in 78%, 28%, 55% and 44% women, respectively. There are many suspected etiologies. Clinical management is the need of an electric and multidisciplinary approach (history, examination, investigation as pelvic MRI, pelvic ultrasound, biological exam). Treatments were various including psychological therapies, psychotropic treatment (56% women reported a persistent reduction of symptom [50%-90%] with clonazepam), transcutaneous electrical nerve stimulation (TENS) . . . Conclusion. - This literature review provides readers with guidance on the management of PGAD. (C) 2012 Elsevier Masson SAS. All rights reserved.