Male Genital Arousal Disorder MGAD): Rare in Men But Real

Highlights: 

• Persistent genital arousal disorder (PGAD), also called genito-pelvic dysesthesia, is a real condition.
• It’s generally defined as either spontaneous orgasms, feeling like you’re about to orgasm, or a need to orgasm to reduce arousal, but orgasm doesn’t work. 
• PGAD is rare in men, but some do experience it.

What Is Persistent Genital Arousal Disorder (PGAD)?

PGAD is a disorder that can happen to men and women, but it’s rarer in men. The disorder is characterized by spontaneous orgasms, the feeling that you’re about to orgasm, or an urgent need to reduce arousal that orgasm doesn’t relieve. 

Sufferers report pressure or discomfort in the genitals, perineum, or anus; engorgement of the genitals; or a pulsing or throbbing sensation. These are usually in the absence of sexual desire or any sort of stimulation. 

Unlike priapism, the presence of an unwanted erection in the absence of stimuli, men don’t need to have an erection to experience these symptoms, and they may not experience an erection at all. PGAD is particularly distressing for men who suffer from other conditions, such as erectile dysfunction (ED.)

How Common is PGAD?

It’s difficult to assess just how common PGAD is; the condition has only been in the medical literature since 2001. Most research has focused on women, but even then, it’s largely online self-report surveys and a limited number of case studies. To the best of current knowledge, up to 1% of women experience PGAD, and right now it’s considered rarer in men. The first confirmed case of PGAD in a man was reported only in 2015, although cases have been reported since then.

What Causes PGAD?

It’s unclear what causes PGAD, but the causes are thought to be the same for men and women. There are a few theories:

Neurological: The nerves in the genitals may be malfunctioning, or surgery in the lower pelvis may damage them. One branch of research seeks to see if there’s any connection between PGAD and restless legs syndrome, and surgery to release entrapped nerves has offered relief to some sufferers.

Vascular: The genitals may be experiencing more blood flow than they need, cueing the body to become aroused in the absence of other stimuli. In some cases in women, a vascular system issue in the clitoris was found and repaired for other reasons by surgeons, which was effective. However, this isn’t a consistent issue.

Pharmacological: Some drugs, or combinations of drugs, may increase blood flow to the genitalia or increase the firing of the nerves. There are some reports that antidepressants may cause PGAD in some women. This is more theoretical than anything else at the moment, and few studies have been done.

Psychological: Finally, the mind can’t be discounted as a factor in PGAD. While it’s unclear if the condition can be induced by psychiatric concerns, some of the more effective treatment methods tend to be psychological in nature. In addition, sufferers report that stress can intensify symptoms. Whether this is due to stress hormones interacting with the body’s systems or a more direct connection needs further research.

In the end, it’s more likely that it’s some combination of the above in many sufferers. There are a few myths about the causes of PGAD that should also be discussed:

• PGAD is not caused by PDE5 inhibitors, a class of vasodilators used to treat erectile dysfunction (such as Viagra, Levitra, Cialis, and others).
• It is not a case of someone being “oversexed.” It’s actually quite the opposite, as PGAD sufferers gain no relief from orgasm.
• Nor is it related to epididymal hypertension, better known as “blue balls.” That condition is caused by blood remaining in the testicles for an extended period of time, and while it can be painful, it’s a temporary condition.

How Is PGAD Treated?

As PGAD isn’t well understood, treatment options are being developed over time, and not all options are viable for all patients.

Generally, PGAD is seen as a symptom of another issue rather than a distinct problem, so doctors will attempt to treat the larger issue. If, for example, the patient has a history of depression, they’ll focus on managing that first, which may also mitigate the PGAD. This will also include basic lifestyle management strategies, such as smoking cessation, reducing alcohol consumption, improving diet, a regular exercise regimen, and stress reduction and management.

For PGAD specifically, while research is ongoing, there are a few promising techniques for both short-term management and long-term treatment.

Pelvic floor exercises: Also called “kegel” exercises, some patients have found that strengthening their pelvic floor offers some relief. As they’re easy to do at home and can be done with minimal equipment, this is generally where a treatment program will start.

Relaxation techniques: One consistent pattern is that PGAD appears tied to stress levels. Something as simple as distraction can assist patients, while hypnosis has also shown some promise. Mindfulness practice can also be a good start and will be relatively easy to implement.

Topical anesthetics: Numbing the area may provide some relief and allow the patient to get on with their day. This can be as simple as an ice-pack or an over-the-counter topical anesthetic. Patients should discuss these options with a doctor, however, as they may not be ideal in all situations or may have problems long term.

Medication: While there is no “magic pill” to treat PGAD, there has been at least one reported case of varenicline, known by the brand-name Chantix, resolving the issue. This happened entirely by accident, as the patient was seeking to quit smoking and was prescribed varenicline for that purpose. As varenicline can have unexpected side effects, this may be a matter of combining lifestyle approaches with the medication to see if you can resolve both issues with a single treatment.

Surgery: If your medical provider determines that yours may be a vascular or neurological cause, such as a pinched nerve, surgery may offer relief. However, it will likely be a last resort due to the risks and possible side effects and only considered if there’s a compelling reason to believe surgical intervention will offer relief.

PGAD is a poorly understood condition, but as doctors learn more about it, it’s becoming one that we can better treat. Making the right lifestyle choices, working to protect your sexual health, staying informed, and being your own best advocate will help you get the treatment you need. 

eDrugstore is Here for You

Whether you are struggling with sexual function issues, such as erectile dysfunction or premature ejaculation, or relationship and intimacy issues, eDrugstore can help. Check out our medication guide or follow the eDrugstore blog for more information about sexual health and other men’s health issues. 

To learn more, visit our page on erectile dysfunction.