Page 107 - GTM-2-4

Global Translational Medicine Persistent genital arousal disorder

described in the literature, including discontinuation process of PGAD. A potential direction for exploring
or prescription of SSRIs, psychoactive drugs, surgical the diagnostic techniques for PGAD is integrating
treatment, transcutaneous electrical nerve stimulation, neuroelectrophysiology as part of the armada of tests.
botulinum toxin, physiotherapy, cognitive behavioral A comprehensive investigation into the neurological
therapy, mindfulness techniques, relaxation exercises, base is essential for the effective management of PGAD.
among others [2,21-23] (Table 1). The wide range of Emphasizing the necessity of a thorough exploration
interventions implies the complexity of this condition and rather than fixating on a single factor will significantly
the need for empirical management to control symptom. contribute a more in-depth and comprehensive viewpoint
Identifying PGAD presents a challenge given its for understanding and a therapeutic direction for this
complexity, prompting clinicians to rely on a thorough condition. This broader investigative approach extends
medical history, physical assessments, and various the boundaries of inquiry and enhances the capacity for
tests including MRI and neuroelectrophysiology for a nuanced comprehension, enabling more precise and
making diagnosis . These tests serve to differentiate targeted interventions. Ultimately, this approach aims
[24]
other potential causes, aiding in the diagnostic to develop more effective and tailored treatments for
individuals affected by PGAD.
Table 1. Factors associated to persistent genital arousal 4. Conclusion
disorder and possible treatments available
The current study demonstrated that a pudendal nerve
Associated conditions
blockage resulted in an immediate decrease in the related
Psychosocial symptom distress symptoms of PGAD in a woman diagnosed with lumbar
Anxiety symptoms/panic disc disease and Tarlov cyst. This clinical case may
Depressive symptoms/suicidality contribute to the management of neurological conditions
Obsessive-compulsive symptoms that affect the sacral region associated with PGAD and also
Sexual/emotional/other trauma highlight the significance of the multidisciplinary team
Catastrophization/hypervigilance involved in the treatment process.
Relationship adjustment Acknowledgments
Overactive/hypertonic pelvic floor muscle dysfunction None.
Lumbar disc disease Annular tear
Pudendal neuropathy Funding
Sacral Tarlov cyst None.
Radiculopathy of sacral spinal nerve roots
within the cauda equina or sacrum Conflict of interest
Use of medications such as trazodone The authors declare that they have no competing interests.
Use of or discontinuation of SSRIs/SNRIs
Abdominal wall nerve neuroma Author contributions
Other medical comorbidities Conceptualization: Lucia Alves da Silva Lara, Tainara
Possible treatments Tavares Menchete
Psychotherapy and other psychological strategies (e.g., cognitive Formal analysis: Lucia Alves da Silva Lara, Tainara Tavares
behavior therapy, decatastrophization, mindfulness, Menchete, Ana Carolina Japur deSá Rosa-e-Silva, Julia
breathwork, self-compassion, etc.) Kefalás Troncon
Sacral/pudendal neuromodulation at the pelvic floor Investigation: Lucia Alves da Silva Lara, Tainara Tavares
Dose adjustment of SSRI/SNRIs Menchete, Rodolfo Silva Bertoli, Fabiola Dach,
Pudendal nerve blockage Amanda Aguiar Loureiro, Debora Aiesha Leite
Electroconvulsive therapy Cantelli
Tarlov cyst surgery or aspiration (with or without fibrin glue) Methodology: Lucia Alves da Silva Lara, Tainara Tavares
Lumbar disc disease surgery Menchete
(e.g., laminectomy, discectomy, annuloplasty) Writing – original draft: Lucia Alves da Silva Lara, Tainara
Tavares Menchete
Abbreviations: SSRIs: Selective serotonin reuptake inhibitors;
SNRIs: Selective serotonin-norepinephrine reuptake inhibitors. Writing – review & editing: Lucia Alves da Silva Lara,
Modified from Goldstein et al. [21] Tainara Tavares Menchete

Volume 2 Issue 4 (2023) 4 https://doi.org/10.36922/gtm.2341