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Persistent Arousal Syndrome Persistent Arousal Syndrome Sandra Leiblum, PhD; Sharon Nathan, PhD Most physicians are familiar with the common sexual complaints of women (ie, hypoactive sexual desire, sexual arousal difficulties, anorgasmia, dyspareunia).These problems are quite prevalent, and are reported either spontaneously or after careful sexual inquiry by the physician. Far less common and more puzzling is the complaint by a small number of women of persistent sexual arousal. Although infrequent, this problem is distressing and perplexing not only because of its mysterious onset, but also because of the feelings of shame and discomfort that tend to accompany the phenomenon. Women who complain of persistent sexual arousal may be young or old, premenopausal or using postmenopausal hormone replacement therapy, married or single. The distinguishing feature of the syndrome is the report of persistent feelings of vaginal congestion and other physical signs of sexual arousal in the absence of any awareness of sexual desire provoking or accompanying this arousal. While the feelings of arousal may lead to a need to masturbate or engage in sexual activity with a partner to relieve the sensation of vaginal congestion, the arousal is only temporarily quelled with orgasm. Indeed, the feeling of arousal may persist for hours, days, or even months. In the majority of cases in which the woman presents in the physicians office, the feeling of unremitting arousal is experienced as intrusive and unwanted. In some instances, however, the feelings of more or less constant arousal are experienced as pleasurable, if mysterious. In these cases, the woman may not want evaluation or treatment. It is for this reason that the phenomenon may be underreported, even though it is a significant aspect of female sexual response that deserves wider recognition and evaluation. DISTINGUISHING FEATURES The distinguishing features of persistent sexual arousal syndrome (PSAS) include the following: * The physiological responses characteristic of sexual arousal (genital and breast vasocongestion and sensitivity) persist for an extended period (hours to days), and do not subside completely on their own. * The signs of physiologic arousal do not resolve with ordinary orgasmic experience, and may require multiple orgasms over hours or days to remit. * These physiologic signs of arousal are usually experienced as unrelated to any subjective sense of sexual excitement or desire. * The persistent sexual arousal may be triggered not only by sexual activity, but also by seemingly nonsexual stimuli or no apparent stimulus at all. * The physiologic signs of persistent arousal are experienced as uninvited, intrusive, and unwanted. When feelings of genital arousal persist for days, weeks, or even months, they can become personally distressing and worrisome. Again, it should be noted that while all the women who presented to the authors were distressed about their symptoms (see Case Reports), it is possible that other women who experience these symptoms do not find them upsetting. It is important to differentiate between PSAS and hypersexuality, with which it may be confused. Although not a common female complaint, hypersexuality has been reported occasionally in women, where it may manifest as high-frequency masturbation, insistent and intrusive sexual fantasies or thoughts, or very frequent coitus. ( more on the internet)... |
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Interesting article, case study #1 was a 81 yr old woman, with a 91 yr old husband.. Case 1 To date, the authors have interviewed 15 women who presented with PSAS, and have heard of dozens more from OB/GYNs and other primary care physicians. Mrs. B was a healthy 81-year-old woman, 95 lb, who had undergone a hysterectomy. She was married to her third husband, a 91-year-old man. She was referred for psychosexual evaluation by her endocrinologist after consulting a number of physicians for the unrelenting feelings of sexual arousal that plagued her. In the questionnaire mailed to patients prior to consultation, she had written that the complaint makes me so upset that I cry, as I cannot function normally; I make mistakes, get very hungry, and do not sleep. She went on to say that I would like the sensations to go away. I want to feel I can make plans and not have the strong sexual desire to make me miserable€not knowing if I'll get satisfied. Her genital sensations were almost continuous, but worsened during the night. She initially sought release from the arousal by initiating intercourse with her husband, but he had not been able to engage in coitus for the past 2 to 3 years due to a cardiac condition. Her husband was supportive and loving, however, and willingly stimulated her manually and with a vibrator whenever she could no longer tolerate the feelings of sexual arousal. Although she was initially orgasmic with masturbation and manual stimulation, it was becoming more difficult to reach a climax, and even if she did, the sensations of arousal persisted. She sometimes masturbated with a vibrator for up to 90 minutes without relieving the unwanted feelings of sexual tension. ______________________________________ Riley described a case of premenstrual hypersexuality that seems similar to PSAS. The case involved a 22-year-old single woman who had lost her job as a result of an intense need to masturbate frequently during the 3 to 4 days prior to menses. She felt the need to masturbate in the lavatory at work up to 12 times daily in addition to sessions at home and even in the car going to work. During these premenstrual days, she reported a continuous state of sexual arousal, with intense tingling in the clitoris and a feeling of vaginal warmth. There was a major increase in genital secretion at this time, which soaked her underclothes and sometimes resulted in a wet patch on her skirt. The genital sensations rose rapidly in intensity, causing her to seek relief through orgasm by self-stimulation; if she did not attain orgasm, the sensations became unbearable. These sensations were not accompanied by sexual fantasies. (More on internet... ) ________________________________________________________________ It's probably more people with this condition than is reported, they had a special on Television on one of the channels that do various research, and they chronicled and showed the story of a woman, who had done many things, trying to deal with her constant urge to engage. she said it began when she was a teen, and persisted many many years... I wonder how many relationships have fell apart because of this, and the woman did not disclose it to the man, and maybe just was in a continual frustrated state, trying to deal with it, or hide it ???
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