SX03
Persistent Genital Arousal Disorder - a Case Study
Thelma, a 64 year old woman with MS (multiple sclerosis), called to report a feeling of constant arousal.
On researching I discovered Persistent genital arousal disorder (PGAD), a disorder that was first described in scientific literature in 2001. It primarily affects woman and its prevalence is unknown possibly related to lack of disclosure. There are various causes postulated such as vascular changes, psychological and central dysregulation, and generally requires assessment on a case by case basis.
Case description: Back to Thelma. Her symptoms started 5-6 years ago, intermittently at first then became constant, located from the clitoris to the vagina and described as a pre-orgasmic feeling. PGAD may or may not be related to MS and a full assessment is advised. It is often associated with feelings of shame, anxiety and isolation. Treatments have been anecdotal and include CBT, hypnotherapy and clitorectomy.
Conclusion: On ruling out all other possible causes we came to the conclusion that it was caused by a spinal MS lesion. We have tried medications to decrease vascular flow without significant effect; she has previously reacted to medications used for dysesthesias. We have discussed her case with colleagues and are currently awaiting the input from women's health. PGAD is a potential symptom of MS which is undoubtedly under recognised and disclosed (background objectives methods results conclusions N/A)