Persistent genital arousal: disordered or normative aspect of female sexual response?

Persistent genital arousal disorder (PGAD), previously known as persistent sexual arousal syndrome, is a serious and extremely distressing condition. Clinical experience suggests that there may be a subset of women who experience persistent genital arousal as a normative and not especially distressing part of their sexuality.

To determine whether there are women who report unprovoked genital arousal and view it as normative, and to identify differences between women who endorse all five features of PGAD vs. those who endorse only some of features.

Respondents were asked about the nature, onset, duration, and severity of their arousal, and their feelings about PGAD. Overall sexual and relationship satisfaction was assessed, as were scores on the Female Sexual Function Index (FSFI).

An on-line, anonymous survey on persistent genital arousal was conducted. Of the 388 respondents, 206 women endorsed all five features of PGAD (PGAD group) and 176 endorsed some, but not all, criteria (non-PGAD group).

The two groups were similar in age, relationship status, and duration. More PGAD than non-PGAD women reported current symptoms and greater symptom severity. Distress ratings were significantly greater for PGAD than non-PGAD women (7.9 vs. 4.7 on a 10-point scale). Forty-eight percent of PGAD vs. 27% of non-PGAD women reported continuous feelings of arousal. Significantly more PGAD women than non-PGAD women endorsed negative feelings about their genital arousal. Women with PGAD reported lower desire, less sexual satisfaction, greater pain, and lower overall scores on the FSFI.

There is a cohort of women who regularly, if intermittently, experience unprovoked and persistent genital arousal and find it mildly pleasurable. Their genital arousal differs from that of women who meet all five criteria for a diagnosis of PGAD. Possible explanations and etiologies for these differing reactions are discussed.