Persistent Sexual Arousal Syndrome (PSAS) / Persistent Genital Arousal Disorder (PGAD)

“Sitting is unbearable, sometimes causing pressure to orgasm. Standing is the only time I feel nothing. Sitting in a car is torture.”

“I was constantly feeling overwhelming sensations of sexual arousal, which were purely physical and not accompanied by romantic or sexual fantasies.”

These are some of the anguished statements made by patients of Persistent Sexual Arousal Syndrome (PSAS) to their doctors and read out in medical forums to emphasize the need for research into this new challenge in women’s sexual health.

Dr. David Goldmeier who described PSAS in a report in the International Journal of STD and AIDS said women with PSAS who have sought treatment have reported extreme distress and even thoughts of suicide.

Considering the rarity with which this syndrome is reported by women it seems fitting to present two sample case reports from women interviewed by Dr. Sandra Leiblum and Dr. Sharon Nathan and reports gathered from obstetricians, gynecologists and other primary care doctors from other parts of the world who were presented with cases of PSAS.

Case Report 1: In 2001, a 52-year-old, divorced, working woman reported having Persistent Sexual Arousal Syndrome (PSAS) for 6 years and that it affected her work and destroyed her wellness. She reported persistent sensations of genital vascocongestion and masturbation offered no relief. With no thoughts of sex, her body would pulsate intensely with a constant need for release, sometimes with a reprieve only at sleep. She thought she was the only woman in the world with this peculiar problem and resorted to taking anti-depressants.

She was thoroughly examined by her family doctor, 3 gynecologists, a urologist, and a mental health specialist—and none of them could help her and had never heard of a distressing abnormality such as hers. The doctors were also baffled that her blood tests and hormone levels and an MRI scan showed normal. She said there was no history of psychological trauma. For six years she used anti-depressant drugs such as divalproex, sertraline, fluoxetine and buspirone that did not help her in any way. She said her sense of humor, support from family and friends helped ward off depression. With no forthcoming explanation or solution from doctors, the woman continues to suffer from PSAS.

Case Report 2: This is a case reported about a patient by a gynecologist in Australia. The patient is a 51-year-old woman with a “continual distressing feeling of sexual arousal.” The patient was unwilling to masturbate and orgasms did not relieve the persistent genital arousals. Androgen values and the results of abdominal computerized tomography covering the adrenal glands, lumbosacral spine and the pelvis were found to be normal. Neurologic findings were also normal. There was a mild tenderness in the suprapubic area. The patient reported using hormone replacement therapy for a few years for osteopenia and was not taking any alternative medicine therapy.

An endocrinologist in Phoenix, US, Dr. Randall Craig claims he has successfully treated two women with PSAS-like symptoms. In his letter posted on PSAS Support Group, he suggests that 3 hormones—progesterone, prolactin and oxytocin may play a role in PSAS. Particularly, women with insufficient oxytocin release after orgasm may experience PSAS symptoms. According to Dr. Craig inhaling oxytocin could relieve patients from symptoms of PSAS.