Restless Genital Syndrome

Restless genital syndrome, or persistent genital arousal disorder, results in a spontaneous, persistent, and uncontrollable genital arousal, with or without orgasm or genital engorgement, unrelated to any feelings of sexual desire.
An article published in Medscape has defined restless genital syndrome as restlessness in the genitals and pelvis. The condition was first described as “persistent sexual arousal syndrome” in 2001 and was thought to have sexual causes. However, it is now understood that there is a link between restless genital syndrome and restless leg syndrome, and that the causes are more than likely to be neurological rather than sexual, hence the change in name.
The condition is poorly understood, according to a British review of the available literature published in the Journal of Sexually Transmitted Diseases and Aids. To date, there has been little research conducted and in research that does exist, there are concerns about the validity of the results.
It has been reported far more significantly in women than men and causes moderate to severe distress in patients, according to research by Professor Sandra Leiblum and colleagues published in the Journal of Sexual Medicine.
Because of the lack of research, the causes of the condition are not well understood. Research conducted by Dr. Thomas Facelle and colleagues published in the Journal of Sexual Medicine indicates that restless genital syndrome may stem from a number of causes, including use of certain medications and psychological, neurological or vascular causes. Some believe that restless genital syndrome is related to priapism.


Physical arousal caused by this syndrome can be very intense and persist for extended periods, days or weeks at a time. Orgasm can sometimes provide temporary relief, but within hours the symptoms return.
In an article written for Medscape, researchers indicated that patients usually complain of discomfort in the genital region. This discomfort includes burning, tingling, throbbing itching or pain in the genitals. She goes on to state that symptoms are often worse when a patient is sitting or lying down than when they are standing or walking. Symptoms are also occur more commonly at night than during the daytime.
The symptoms can be debilitating, preventing concentration on mundane tasks. Some situations, such as riding in an automobile or train, vibrations from mobile phones, and even going to the toilet can aggravate the syndrome unbearably causing the discomfort to verge on pain. It is not uncommon for sufferers to lose some or all sense of pleasure over the course of time as release becomes associated with relief from pain rather than the experience of pleasure. Some sufferers have said that they shun sexual relations, which they may find to be a painful experience.
The condition may last for many years and can be so severe that it has been known to lead to depression and even suicide.


Because the condition has only been described relatively recently, the treatment guidelines for restless genital syndrome have not yet been defined. The symptoms can sometimes be reduced by the use of antidepressants, antiandrogenic agents, and anaesthetising gels. Psychotherapy with cognitive reframing of the arousal as a healthy response may also be used.
More recently, the symptoms of the condition have also been linked with pudendal nerve entrapment. Regional nerve blocks and less common surgical intervention have demonstrated varying degrees of success in most cases. There is, however, no evidence for the long-term efficacy of surgical intervention.
In one recent case, serendipitous relief of symptoms was noted from treatment with varenicline, a treatment for nicotine addiction.
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