Author: Dr. Christian Reutter, Pelvic Rehabilitation Medicine in New York City
Due to stigma and underreporting, the actual prevalence of Persistent Genital Arousal Disorder (PGAD) may be higher than reported. While PGAD is more commonly reported in females, it can also affect males, although less frequently. It is estimated to impact anywhere from 0.6% to 4.3% of the population, predominantly affecting females. However, the prevalence of PGAD in the male population remains unknown.
What is PGAD in men?
Persistent Genital Arousal Disorder (PGAD) is a rare condition characterized by spontaneous and persistent genital arousal without sexual desire or stimulation. The symptoms are not diminished with orgasm. It can result in distress and greatly impact one’s quality of life.
What are the symptoms of PGAD?
Symptoms of persistent genital arousal disorder include:
- persistent genital arousal without sexual desire or stimulation,
- spontaneous erections
- discomfort or pain in the genital area
What are the risks and causes of PGAD?
- Neurological cause is often compression of the dorsal branch of the pudendal nerve (it transmits the perception of stimulation from the penis which is then interpreted as arousal)
- Weaning off of certain antidepressant medications
- Tarlov Cyst
- Repetitive stress/Trauma
How is male PGAD diagnosed?
There are challenges in diagnosing PGAD, including the lack of specific diagnostic criteria and the overlap with other conditions like hypersexuality or priapism. There is no objective method of detecting or diagnosing PGAD, however, a careful physical exam correlated with a thorough patient history can help.
MRI can help to identify causes of nerve compression, including Tarlov cysts, and confirm any abnormalities in the nerve or adjacent structures.
How is PGAD treated?
There is normally a multidisciplinary approach to managing PGAD, involving physical therapy, pelvic floor specialists, and sometimes psychiatry. Treatment should first focus on reversing any underlying causes of PGAD.
Depending on the condition’s cause, treatments such as psychotherapy, pelvic floor exercises, and lifestyle modifications are a good start. But, if the nerves and muscles of the pelvic floor are part of the cause, patients can greatly benefit through treatment with PRM.
Medication management typically includes neuromodulator medications like Lyrica or Cymbalta, although their efficacy is variable. If there is pelvic floor muscle hypertonia (spasm), muscle relaxant suppositories are often prescribed.
The PRM Protocol ™ is a proprietary, office-based treatment which is highly beneficial, and consists of a series of pelvic nerve and muscle treatments to directly target the spastic pelvic floor muscles, inflammation in the pelvis, and nerve irritation. The nerve that is typically targeted is the pudendal nerve and its dorsal nerve branch. The targeted muscles typically include the pelvic floor muscles, including the puborectalis, pubococcygeous, and iliococcygeous muscles.
Learn more about treatment at PRM
How does PGAD affect quality of life?
PGAD can have a great emotional and psychological toll on males, including anxiety, depression, and difficulties in relationships.
Providing supportive care, counseling, and education for patients and their partners is important.
Schedule Your Appointment
At PRM, we care for our patients by helping them to understand their pelvic pain conditions, and guide them through treatment that directly targets the source of their symptoms. Schedule your appointment with a pelvic pain specialist today.
