Persistent genital arousal disorder - the present knowledge.

Persistent genital arousal disorder (PGAD) is a relatively recently described sexual disorder, characterized by symptoms of spontaneous genital arousal which persist in the absence of sexual desire and may affect women and men. Epidemiological studies conducted so far indicate that the prevalence of PGAD in the population may reach 1-4%. The etiology of PGAD remains unclear and complex, hypothesized causes include vascular, neurological, hormonal, psychological, pharmacologic, dietary, mechanical factors or a combination of these factors. Proposed methods of treatment include pharmacotherapy, psychotherapy, electroconvulsive therapy, hypnotherapy, injection of botulinum toxin, pelvic floor physical therapy, application of anesthetizing agents, reduction of identifiable factors exacerbating the symptoms, and transcutaneous electrical nerve stimulation. There is no standardized treatment algorithm for PGAD due to lack of clinical trials (evidence-based medicine). The classification of PGAD is under discussion: it could be classified as a separate sexual disorder, a subtype of vulvodynia or a disorder with pathogenesis similar to overactive bladder (OAB) and restless legs syndrome (RLS). Due to specificity of symptoms, patients may feel shame and discomfort during the examination or even delay reporting symptoms to the specialist. Thus, it is crucial to spread knowledge about this disorder, which would allow doctors to diagnose and help PGAD patients sooner.