Treatments for Persistent Genital Arousal Disorder in Women: A Scoping Review
Open accessAbstract
Background: Persistent genital arousal disorder (PGAD) is characterized by elevated discomfort associated with persistent genital arousal in the absence of sexual desire. Aim: To perform a scoping review of the proposed treatments for PGAD and their efficacy. Methods: A scoping review was carried out (PRISMA-Scr) that included articles on PGAD as the main disorder, only in women, which explained, in detail, the treatment and its efficacy, was empirical, was written in English and Spanish. No prior filtering by years was performed. Outcomes: Three different effective treatments were found (physical therapies, pharmacological therapies, and psychotherapeutics in combination with other therapies). Results: Thirty-eight articles were selected. From physical therapies, treatments using neuromodulation, transcutaneous electrical stimulation, Botox, surgery, electroconvulsive therapy, manual therapy, pelvic floor therapy, dietary changes, and transcranial magnetic stimulation showed effectiveness. Using the pharmacological approach, paroxetine, duloxetine, pramipexole, ropinirole, and clonazepam treatments were effective. Psychotherapy treatments showed effectiveness only in combination with other types of treatments, specifically a combination of cognitive–behavioral strategies with pharmacological treatment. Clinical implications: Pharmacological treatment, specifically SSRIs, have proven to be the therapy of choice for different subtypes of patients. Strengths and limitations: This study analyzed treatment effectiveness with different approaches and took into consideration those articles where psychotherapy was used as a combination treatment with pharmacological and physical therapy. The main limitation is that it was focused exclusively on women, and the results cannot be generalized to include men. Conclusions: To date, a combination of pharmacological interventions with physical therapy and, in some occasions, with psychological therapy is main strategy followed to accomplish effective treatment of PGAD.
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Clear evidence-based treatment recommendations for PGAD/GPD do not yet exist.
“there are not yet clear evidence-based treatment recommendations for those suffering from PGAD/GPD”
From Psychological Treatment of Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia Using an Integrative Approach (2023) · cites this paper as Martín-Vivar et al., 2022
The Conclusions call for standardized clinical guides and scientific consensus on PGAD treatment, supporting the claim that clear evidence-based recommendations are lacking. The Limitations state that the review covers women only and its results cannot be generalized to men, whereas the citing sentence refers to everyone with PGAD/GPD. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe scoping review identified only seven studies examining psychological interventions for PGAD/GPD, all of which were case studies.
“Notably, the scoping review only identified seven studies which examined psychological interventions, all of which were case studies.”
From Psychological Treatment of Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia Using an Integrative Approach (2023) · cites this paper as Martín-Vivar et al., 2022
Evidence to date indicates that psychological, pharmacological, and physiological treatments may be suitable and effective for PGAD/GPD.
“current evidence suggests that psychological, pharmacological, and physiological treatment approaches may be appropriate and effective”
From Psychological Treatment of Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia Using an Integrative Approach (2023) · cites this paper as Martín-Vivar et al., 2022
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Merwin, K. E., & Brotto, L. A. (2023) · Archives of Sexual Behavior · doi:10.1007/s10508-023-02617-3 · Cited by 8 · see citing works
“A scoping review of proposed treatments for PGAD/GPD (Martín-Vivar et al., 2022) identified 38 studies and found evidence for physical treatments such as surgery, neuromodulation, and pelvic floor physiotherapy; pharmacological approaches such as the use of paroxetine, duloxetine, and clonazepam; and psychotherapy app…”
BackgroundMethod
- Authors
- Martín-Vivar, M., Villena-Moya, A., Mestre-Bach, G., Hurtado-Murillo, F., & Chiclana-Actis, C.
- Affiliations
- Universidad Francisco de Vitoria (ES)
- Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana , Madrid , Spain
- Universidad Internacional de la Rioja, Center for Sexual and Reproductive Health , La Rioja , Spain
- Hospital Universitario Doctor Peset (ES)
- ORCID
- Martín-Vivar, María
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-04-06
- Volume
- 19
- Issue
- 6
- Pages
- 961-974
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W4223590336
- Cited by
- 19
- References
- 56
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 6 · 2023: 3
- FWCI
- 0.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- Deposito Digital UFV (Francisco de Vitoria University) (submittedVersion, cc-by-nc-nd)
- Re-Unir (International University of La Rioja) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- persistent genital arousal disorder, women, treatment efficacy, pharmacotherapy, selective serotonin reuptake inhibitors, paroxetine, duloxetine, pramipexole, ropinirole, clonazepam, neuromodulation, transcutaneous electrical stimulation, onabotulinumtoxinA, electroconvulsive therapy, pelvic floor physiotherapy, cognitive behavioral therapy, combination therapy, physiotherapy
- MeSH terms
- Urogenital Diseases, Arousal, Female, Genitalia, Humans, Libido, Male, Sexual Dysfunctions, Psychological
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