For people living with PGAD, feeling unwanted physical arousal symptoms without sexual desire can cause distress, physical pain, and interfere with daily activities.

Persistent genital arousal disorder (PGAD) can cause symptoms similar to what you may feel when sexually aroused, such as clitoral swelling or erections. It can also generate unexpected orgasms, even without sexual thoughts, desire, or stimulation.

If you are living with or think you may have PGAD, you may feel shame and embarrassment about what’s happening to you and may not want to talk with your doctor about it. If you have a partner, you may also experience relationship difficulties because of PGAD.

Although PGAD is not well understood, you are not alone. What you’re experiencing is real and may have physical or mental health causes that can be treated effectively.

According to an older 2014 case report, persistent genital arousal disorder (PGAD) was first described by psychiatrists in 2001. It can happen to people assigned male or female at birth, but is most common among females. However, it is a rare and poorly understood condition that is thought to impact only a small number of individuals.

Folks with PGAD have a continual feeling of unwanted sexual arousal, including swelling of the genitals, sensitivity, or spontaneous orgasms, even when there is no sexual stimulation to cause it.

A 2021 research review showed that approximately 0.6% to 3% of females worldwide have the condition. Still, PGAD is likely underdiagnosed, as many people who experience it may be embarrassed to discuss their symptoms with their healthcare professionals.

PGAD is not the same as hypersexuality, “sex addiction“, or “masturbation addiction.”

Note that, as outlined by the American Association of Sexuality Educators, Counselors and Therapists (AASECT), these are not true addictions and are not recognized as mental health conditions.

If you have PGAD, symptoms occur in the absence of sexual desire, can significantly interfere with daily activities, and cause distress, anxiety, and depression.

PGAD may begin in adolescence or first appear in adulthood and can impact your ability to work, socialize, or engage in daily activities.

Symptoms of PGAD include:

  • sudden and frequent physical feelings of sexual arousal that persist for an extended time (hours, days, or weeks) without a reason
  • arousal related symptoms, such as elevated heart rate, rapid breathing, or muscle spasms
  • persistent swelling and sensitivity, tingling, aching, or pressure in the genitals
  • unexpected and unwanted spontaneous orgasms
  • inability to feel relief even after one or more orgasms
  • mental health symptoms such as anxiety, depression, or thoughts of self-harm or suicide

According to a small 2020 study, PGAD primarily affects females. Researchers suggested there are only 5 to 6 reports of the condition in males.

However, that reported number may be low as many people assigned male at birth may not feel comfortable seeking treatment due to the social stigma often attached to sexual health. Females may also feel this way, which could be why the condition might be underreported in general.

In males, sudden and unwanted genital arousal or orgasm can be more obvious than in females. This can lead to additional feelings of shame and embarrassment when symptoms occur in public.

PGAD can also negatively affect relationships. The frequency of symptoms, combined with the lack of knowledge about the condition can cause difficulties between intimate partners, friends, and family members.

Persistent sexual arousal syndrome (PSAS) and restless genital syndrome (RGS) are terms sometimes used to describe the symptoms of continual genital arousal without sexual desire.

However, because these symptoms are not triggered by desire for sex and can cause significant interruption in daily activities, many health professionals now use PGAD to more appropriately label the condition.

In males, PGAD can cause persistent erections that last a long time and frequently reoccur, even after ejaculation. Priapism also causes these symptoms, so the two terms are often interchanged.

However, priapism can occur with other medical conditions or the use of medications to treat erectile disorder (ED). So, if you or your partner experience an erection that lasts longer than 4 hours that’s not caused by sexual stimulation, seek medical care right away.

The cause of PGAD is not well understood. However, scientists suggest several factors may contribute to symptoms.

These include:

Scientists who conducted the 2020 study found evidence that the presence of Tarlov cysts and disorders of the spinal cord may be the most likely cause of PGAD in people with those conditions.

The researchers also suggested that because females are more likely to have Tarlov cysts, this would explain why PGAD is more prevalent in people assigned female at birth.

The frequency of PGAD is not fully understood, but the condition may happen more often to people:

  • assigned female at birth
  • stopping or changing some antidepressant medications
  • living with certain spinal conditions
  • living with pelvic area injuries or trauma

PGAD treatment options are limited, but researchers continue to identify ways to help people with this condition manage or eliminate symptoms.

Some therapies thought to work include:

Although research is limited, one 2021 case report suggested a drug used to treat Parkinson’s disease called pramipexole may reduce symptoms in people who experience PGAD when changing medications for their mental health condition.

For females, a small 2021 study suggested engaging in online pelvic floor education programs may help reduce the frequency of symptoms.

If you live with PGAD, it may be helpful to understand that what you are experiencing is not your fault. The arousal symptoms you may experience are not caused by an uncontrolled desire for sex.

It is a real condition with physical symptoms that can be distressing and cause a great deal of angst, anxiety, and depression.

Although not much is known about why PGAD occurs, scientists and health professionals are continually learning more about the causes and identifying effective treatment options.

For more information and support, there are Facebook groups that can help. These include: