What Is the Persistent Sexual Arousal Syndrome?

Woman's priapism

Persistent Sexual Arousal Syndrome (PSAS) represents a spontaneous and persistent genital arousal (accompanied also by breast congestion), with or without orgasm or genital engorgement/swelling/lubrication, but not linked to a higher sex drive (patients are annoyed by this arousal) and which generally is unwanted and intrusive. It has nothing to do with hypersexuality (nymphomania). Those experiencing this rare condition frequently report shame or embarrassment.

The physical arousal can be very intense and persistent, for days or weeks at a time. Orgasm can sometimes induce temporary relief, but no mater how much sex intercourse/masturbation is practiced, after several hours the symptoms come back. Clearly, sex does not help in this case; not even 300 spontaneous orgasms/day in a reported case. Anyhow, a partner coping with such sexual demands is impossible to be found, not to mention men can feel dominated by such women. The syndrome can appear on "spot" areas, like deep in the vagina, or in the clitoris area.

They can impair a subject's activity, impeding him/her to concentrate on daily tasks. Some situations, like riding in an automobile or train, mobile phone vibrations, and even bath use can exacerbate the syndrome, turning it unbearable. And everything starts strong sexual urges.

"Sitting is unbearable, sometimes causing pressure to orgasm. Standing is the only time I feel nothing. Sitting in a car is torture. The opening of the vagina is just as sensitive and a mere touch will bring me to orgasm. My husband is very sympathetic and relieves the terrible pressure anytime I ask. Those close to me that I've told about this at first think it's funny and then realize that indeed it is not."

"I was constantly feeling overwhelming sensations of sexual arousal, which were purely physical and not accompanied by romantic or sexual fantasies. Basically I felt the need to have repeated orgasms which was never relieved by normal orgasmic experience." These are testimonies of PSAS patients.

The partner can feel helplessness and confusion, uncertainty in providing relief, feelings of inadequacy, isolation and lack of support from family and peers, frustration and anger. The patient can experience shame and isolation, feelings of helplessness, vulnerability and sadness, being awakened in the morning by hot flashes, and a feeling of a lack of normalcy.

You can imagine the impairment in social life and keeping a job. Nobody holds an employee that goes so often to the bathroom.

For the moment, doctors can only guess an impairment in sensory nerves as the main case, as the diseases tend to prevail in post-menopausal women in their 40s and 50s, or those who followed hormonal treatment; still, there have also been signaled cases of women in their 30s. Others say it could be linked to the brain's limbic system, the center of pleasure and sex physiology. A brain tumor in an area receiving signals from the genitalia area has been recorded in a case. Ovary tumors have been also reported.

Some drugs like trazodone induce PSAS as a side effect. Sometimes, PSAS starts after stopping SSRIs (a class of antidepressants) or cholesterol-lowering treatments. One patient developed PSAS following surgery for urethral prolapse. Some cases are provoked by a pelvic arterial-venous malformation with arterial branches to the penis or clitoris; surgery is effective in this case.

Symptoms can be decreased with antidepressants, antiandrogenic agents and anaesthetising gels; medical treatment of irritating neurologic lesions, psychotherapy also helps.

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