Persistent Sexual Arousal Syndrome

Persistent sexual arousal syndrome (PSAS) sounds like a condition dreamed up for a TV medical drama. In fact, Grey’s Anatomy based an entire episode on a female character who couldn’t stop having orgasms and would have to masturbate five times a day. But the ailment wasn’t a figment of a TV writer’s imagination: PSAS is in fact a real condition that affects thousands of women.

While this situation might seem desirable, funny, or just plain weird, it is actually akin to being hijacked by your body: Your body acts completely independent of your own desire. PSAS, also referred to as persistent genital arousal disorder (PGAD), is an unwanted, intrusive, nonsexual arousal of the genitals that is not triggered by thoughts of sex or feelings of desire. The symptoms can include restless legs, tingling sensations in the genitals that crescendo to a need for release via an orgasm (and can return at any time), and also tightness in the lower back, hips, and pelvic muscles.

Physical arousal caused by this syndrome can be very intense and persist for days or weeks at a time. Orgasm can sometimes provide temporary relief, but within hours — or minutes — the symptoms return (and are sudden and unpredictable).

The Mystery Surrounding PSAS
Like so many who suffer from sexual dysfunction, women with PSAS think they are abnormal, even freaks, and wonder whether they are the only ones who could possibly have this complex condition. For a long time, members of the mainstream medical community didn’t acknowledge PSAS. Even today, while there are gynecologists and other doctors familiar with this condition, many women are still diagnosed with psychiatric problems after describing their symptoms.

Still, nobody really knows what causes this strange ailment or what sets off these sensations, except for a few known triggers. It is not related to hypersexuality (which is also known as nymphomania in a woman or satyriasis in a man). A Dutch study connected PSAS with restless legs syndrome. Other factors that may be involved include muscle tension in the low back, hip flexors, and outer pelvic region, which could be constricting blood flow and putting pressure on the nerve endings. The origin could also be related to a neurotransmitter that has backfired in the brain or from suddenly discontinuing certain medications, including a selective serotonin reuptake inhibitor (SSRI), often used to treat depression. Also, hormones may be a contributing factor: Puberty, child-bearing years, and the pre- or post-menopausal years appear to be when the majority of women experience PSAS.

Men share a similar problem with unwanted and prolonged arousal called priapism, which is a condition in which a penis remains engorged for more than four hours. In males it is a medical emergency that may lead to complications such as blood clots and gangrene.

The Difficult Reality of PSAS
PSAS affects women differently, but the impact upon their lives can be equally devastating. Many of the women who have been studied report being distressed and having to masturbate all day long to try to get relief. It is intrusive and exhausting. Not surprising, women with PSAS experience anxiety and depression.

In addition to being very difficult to manage on a daily basis, most women see their condition as shameful and embarrassing. Sadly, it robs a woman of satisfaction and sexual self-expression. Unfortunately for these women, pleasure very often becomes forever associated with pain. Research is still ongoing, but thus far therapy and medication, such as anti analgesic-gels, have been used to treat this syndrome with some success.