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A HUNDRED ORGASMS A DAY: PGAD

A HUNDRED ORGASMS A DAY: PGAD . Prof ihab younis www.redsulfur.net. “ Other women wonder how to have an orgasm … I wonder how to stop mine" .

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A HUNDRED ORGASMS A DAY: PGAD

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  1. A HUNDRED ORGASMS A DAY: PGAD Prof ihabyounis www.redsulfur.net

  2. “Other women wonder how to have an orgasm … I wonder how to stop mine"

  3. “When I describe it to men, I tell them, ‘Imagine having an erection that does not go down, all day, all night, no matter how many times, no matter how much you’ve destroyed the skin on your penis” Gretchen Molannen (39), who suffered from PGAD for 16 years, was found dead of a suicide in her Spring Hill, Fla., home the day after a story she had participated in with the Tampa Bay Times appeared online

  4. The disorder was first described by Leiblum &Nathan in 2001 • They reported five cases and named it ”persistent sexual arousal syndrome (PSAS)” Leiblum SR, Nathan SG:Persistent sexual arousal syndrome: a newly discovered pattern of female sexuality. J Sex Marital Ther. 2001 Jul-Sep;27(4):365-80

  5. What is arousal in women?? • Engorgement of sexual tissues such as nipples, vulva, clitoris, vaginal walls with vaginal lubrication • It is the counterpart of erection in men تم إزالة الصورة بواسطة الرقابة على المصنفات العلمية

  6. components

  7. Genital swelling & • sensitivity • ± Nipple • swelling • Persist for hours or days and do not subside completely on their own

  8. 2. Arousal is unrelated • to any sense of desire Difference from mania

  9. 3. arousal is triggered by sexual • & non-sexual stimuli • Riding a car or a train • Using a washing machine • Vibrations of mobile phones • Or by no apparent stimulus

  10. 4. Symptoms return sudden ly, unpredictable and unwanted

  11. 5. The symptoms cause, at least, a moderate degree of distress • Goldmeier D et al:Persistent genital arousal disorder: a review of the literature and recommendations for management.Internat J STD & AIDS 2009; 00: 1–5

  12. Some sufferers avoid sexual relations, because they find it a painful experience The condition may last for many years and can be so severe leading to depression & even suicide • Tragedy as woman with debilitating sexual arousal disorder ... commits suicide, The Daily Mail, 4 Dec 2012. Retrieved Dec 2012

  13. Ninety six randomly chosen women completed a questionnaire regarding spontaneous and persistent GA How frequent ? • Garvey LJ, West C, Latch N, Leiblum S, GoldmeierD. Report of spontaneous and persistent genital arousal in women attending a sexual health clinic. Int J STD AIDS. 2009 Aug;20(8):519-21.

  14. Awareness of sensations of genital arousal is quite normal for some women • It may be experienced as mildly pleasurable or mildly annoying Leiblum SR. Persistent Genital Arousal Disorder: What It Is and What It Isn’t. Contemporary Sexuality- Update. 2006, Vol. 40, No. 10

  15. CLOUDY ETIOLOGY

  16. MEDICATIONS • Finger, William W., Lund, Margaret and Slagel, Mark A. "Medications that may contribute to sexual disorders: a guide to assessment and treatment in family practice". J FamPract , 1997, 44 (1): 3 • Goldmeier D, Leiblum SR. Persistent genital arousal in women - a new syndrome entity. Int J STD & AIDS, 2006; 17:215-6.

  17. Neurological dysfunctions AND

  18. PGAD was linked with pudendal nerve entrapment during pregnancy • Symptoms disappeared after physiotherapy Rosenbaum T Y.Physical Therapy Treatment of Persistent Genital Arousal Disorder During Pregnancy: A Case Report. J Sex Med 2010;7:1306–1310

  19. VASCULAR CAUSES • Goldstein I, De EJB, Johnson J. Persistent sexual arousal syndrome and clitoral priapism. In: Goldsein I, Meston C, Davis S, Traish A, eds. Women’s sexual function and dysfunction: study, diagnosis and treatment. London: Taylor and Francis; 2006:674-85 Thorne C, Stuckey B. Pelvic congestion syndrome presenting as persistent genital arousal: a case report.J Sex Med. 2008 5(2):504-

  20. “And where does this woman live?” ÷ • Nappi R, Salenia A, Traish AM et al. Clinical biologic pathophysiologies of women’s sexual dysfunction. J Sex Med 2005;2:4-25 Inn

  21. Leiblum published 3 papers about etiology of PGAD using web questionnaires(# 491)

  22. Some findings in the 3 studies

  23. The • average • age was • 40.05 ±12.5

  24. Arousal PGAD Non-PGAD • Unrelated to desire 100% 62.5% • Does not resolve by orgasm 100% 66.7% • Intrusive 100% 66.7% • Cause at least mod.distress 100% 58.3%

  25. The longest period without symptoms PGAD Non-PGAD • < 24 hours 41.2% 22.2% • < one week 26.5% 31.1%

  26. Physical health • Back pain • Thyroid problems • Hypo and Hypertension • Neurological problems • Diabetes • Chronic fatigue syndrom* *Significant difference between PGAD & Non-PGAD

  27. Psychiatric health PGAD Non-PGAD • Depression 57.9%39.6% • Anxiety 42.1% 27.1%

  28. Sexual abuse PGAD Non-PGAD • As a child 52.6% 43.8% • As an adult 35.5% 22.9% • Did it contribute to your persistent arousal 11.8% 16.7%

  29. Negative feelings about PGAD PGAD Non-PGAD • Frustrated 85.5% 56.3% • Distracted 76.3% 58.3% • Worried 56.6% 35.4% • Depressed 44.7% 27.1%

  30. Positive feelings about PGAD PGAD Non-PGAD • Sexy 17.1% 41.7% • Pleased 14.5% 31.3%

  31. TREATMENT

  32. Since the etiology is not established, No satisfactory treatment is available • The following treatments were used in case reports

  33. General measures • Avoiding factors that induce PGAD • Masturbation can • lead to temporary • relief of mild forms

  34. In severe forms, orgasms only perpetuate symptoms • Simple procedures such as using ice packs on the area may be helpful Goldmeieret al. Persistent genital arousal disorder: a review of the literature and recommendations for management. Int J STD AIDS, 2009;20(6):373-7.

  35. Anticonvulsants • Philippsohn S & Kruger T H, PGAD:Successful treatment with Duloxtine&Pregabalin in two cases. J Sex Med, 2012;9(1):213-7.

  36. Antipsychotics • Wylie K, Levin R, Hallam-Jones R, Goddard A. Sleep exacerbation of persistent sexual arousal syndrome in a post menopausal woman.J Sex Med 2006;3:296–302.

  37. Smoking cessation drug Korda JB, Pfaus JG, Goldstein I.Persistent Genital Arousal Disorder: ACase Report in a Woman with Lifelong PGAD Where Serendipitous Administration of VareniclineTartrateResulted in Symptomatic Improvement.J Sex Med. 2009;6(5):1479-1486. • Varenicline (Champix®) symptoms relieved within 2 weeks but returned after 2weeks

  38. ECT

  39. Surgeryy • Surgical release of pudendal nerve entrapment • has resulted in PGAD symptom improvement • Irwin Goldstein. PGAD: Treatment. http://www.sexualmed.org/index.cfm/sexual-health-issues/for-women/pgad-women/treatment/2010

  40. The proposed treatments • do not completely eliminate the condition • They may help reduce the pain, stress and discomfort • Mariana A. PGAD in elderly women:A case study. J IMAB - Annual Proceeding (Scientific Papers) 2012, vol. 18, book 3

  41. A HUNDRED ORGASMS A DAY: PGAD THANK YOU

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