An endless orgasm?

It might sound like a dream come true, but for those suffering from persistent genital arousal disorder (PGAD), the condition is an absolute nightmare. Since so many people have the opposite problem — low libido — it’s hard to grasp that this disorder is anything more than a bother. At first glance, PGAD seems like something to envy.

After all, women with PGAD have intense, spontaneous orgasms. These powerful, involuntary reactions can happen day or night, and the climax can last for several minutes.

For many, the motor that never runs out of gas is laughable as PGAD sensations have been described as a tickle that won’t go away. Yet when you consider that some women have gone so far as to seek relief with electroconvulsive therapy, this is no laughing matter.

Uncomfortable, agonizing and unwanted physiological responses last for hours, even days — and they don’t subside entirely on their own.

Click here to read "Never Satisfied: The Curse of Persistent Sexual Arousal Syndrome," the story of two women who suffer from the disorder.

PGAD, also known as persistent sexual arousal syndrome, was first diagnosed in 2001. Its primary feature is a feeling of constant genital arousal for extended periods of time, despite having one or more orgasms. It is thought that women have suffered from this condition for generations, but have been too guilty, ashamed or embarrassed to report it.

Back in 1903, German psychiatrist Baron Richard von Krafft-Ebing described nymphomaniac women who mirrored PGAD in some ways. For example, they were tormented by sexual excitement, like vibrations and pulsations, in the genitals. Yet nymphomaniac women also described sexual thoughts and fantasies, whereas the women being diagnosed with PGAD did not. Women with PGAD experience intense genital congestions and sensations without any conscious awareness of sexual excitement.

In some cases, PGAD is triggered by sexual activity or nonsexual stimuli. But in many cases, feelings seemingly appear out of nowhere and are focused in the genitals. It doesn’t matter what she’s doing or where, a woman with this condition doesn’t feel sexual excitement or desire despite her body’s reactions. She feels awkward, distracted and even disturbed by these orgasmic fits.

Attempts at relief include self-pleasuring or having sex with a partner. Yet these sexual activities provide only temporary relief or actually exacerbate the problem. It is the lack of relief and the feelings of distress that led to this state being deemed a disorder.

Making matters worse are the confusion and lack of understanding people have about this condition. Others tend to be judgmental about PGAD, mistaking it for a type of nymphomania or hypersexuality. The women afflicted ultimately feel shamed, invalidated, embarrassed, helpless, unsupported, isolated, frustrated and angry. These feelings, combined with the disorder, can disrupt a woman's education, socialization and work. Her relationship often takes a hit as well, as her partner feels confused and isolated.

While the prevalence of PGAD is unknown, an expectedly large number of women are disclosing that they suffer from this condition.

Dr. Sandra Leiblum, former director of the Center for Sexual and Relationship Health at the Robert Wood Johnson Medical School in New Jersey, is perhaps the country’s foremost expert on PGAD.

Her most recent study on the issue, which appeared in a 2005 issue of the Journal of Sexual Medicine, involved more than 100 women. She found that most of these woman who had the disorder were “well-educated, in relatively good health, and in long-term relationships.”

To date, there is no explanation for the disorder. While researchers are still trying to figure out what causes PGAD, in "Textbook on Female Sexual Dysfunction," Dr. Irwin Goldstein, the head of the Sexual Health Program at Alvarado Hospital in San Diego, summarized that possible reasons may include one or more of the following:

— Neurological changes like brain anomaly, post-injury or pelvic nerve hypersensitivity;

— Vascular changes, like pelvic congestion;

— Pressure against genital structures;

— Medications, such as the start or discontinuation of anti-depressants;

— Psychological issues.

Leiblum has added intense masturbation or partner stimulation, emotional stress, anxiety and starting or stopping a hormone regimen as possible causes.

Some women report having experienced PGAD since childhood, while others report the onset as being after childbirth or menopause.

Currently there is no cure for PGAD, but there are some methods used that attempt to help women cope with the problem: Numbing agents (such as ice), pelvic massage or stretching exercises to reduce tension, mood stabilization, anti-seizure medications, increasing partner communication and/or therapy and education to reduce emotional stress.

By working with a therapist or physician, emphasis is often put on directing attention away from the genitals and arousal. This is no small feat.

An online support group is available at: for those wanting more assistance.

Dr. Yvonne K. Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, "Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots."

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