Can pharmacotherapy help persistent genital arousal disorder?

Introduction: Persistent genital arousal disorder (PGAD) is a presumably rare, although debilitating condition, which was first defined only at the beginning of this century and has not yet found consideration by any of the international classification systems of diseases. As affected patients can suffer tremendously, this report aims at providing an overview and an expert opinion on the few existing studies and case reports, guiding clinicians in the treatment and pharmacotherapy of PGAD.Areas covered: In this article case reports, case series and surveys on drugs that may both alleviate or worsen/induce PGAD are reported.Expert opinion: Data on pharmacological treatment options in PGAD are sparse and mainly rely on case reports making conclusions difficult. Most importantly, some drugs such as serotonin reuptake inhibitors (SSRIs) may even induce or worsen PGAD during treatment or withdrawal. We now need an initial spark in order to promote basic research on the etiology of PGAD as well as clinical trials on possible treatment options. In the meanwhile, clinicians should provide careful diagnostics and counseling for affected patients. In case pharmacotherapy is desired, drugs that are able to inhibit sexual excitation and/or modulate sensory perception such as pregabalin or duloxetin might be worth a trial.