Sexual health · 6 min read
Persistent genital arousal disorder (PGAD)
Unwanted arousal that won't switch off is real, distressing and treatable as a whole-person condition.
Written and clinically reviewed by Vanessa Cushing, LPC, NCC, MS — AASECT-Certified Sex Therapist, licensed in Virginia & Florida. The Cushing Counseling team covers Virginia, DC, Maryland & Florida.
The short answer
Persistent genital arousal disorder (PGAD) means unwanted, persistent sensations of genital arousal — tingling, throbbing, pressure or fullness — that aren't tied to desire and don't go away with orgasm, or return quickly. It is real and under-recognised. Good care combines a medical evaluation with psychological support for the distress it causes.
Book a free 15-minute consultation
If this is wearing you down, a free 15-minute call is a private, shame-free first step.
What PGAD can feel like
- Genital sensations of arousal you didn't choose and don't want.
- Sensations that have nothing to do with sexual thoughts or desire.
- Orgasm bringing little or only brief relief.
- Symptoms some people notice more when sitting, with certain clothing, or with vibration such as a car ride.
- Shame, fear, poor sleep and difficulty concentrating.
It is not a high sex drive
PGAD is often misunderstood — sometimes even by doctors — as hypersexuality. It isn't. Most people with PGAD describe the sensations as intrusive and exhausting, not pleasurable.
An international expert panel (ISSWSH, 2021) notes the condition can take a serious emotional toll, including thoughts of suicide. If you are having those thoughts, call or text 988 in the US right away.
A newer name: PGAD/GPD
In 2021 the International Society for the Study of Women's Sexual Health broadened the name to PGAD/genito-pelvic dysesthesia (PGAD/GPD), recognising that many people also have other uncomfortable genital or pelvic sensations. The panel recommends a biopsychosocial approach — looking at the body, the mind and life context together.
Who to see
Because PGAD can have several contributing causes, care often involves more than one specialist. Depending on your symptoms, that may include a sexual medicine physician, gynecologist or urologist, a pelvic floor physical therapist, and sometimes a neurologist. Bring a list of current and recently stopped medications.
We work alongside medical providers and pelvic floor therapists, and can coordinate care with your permission.
How sex therapy helps
- Lowering the distress and fear that make symptoms feel worse.
- Mindfulness, acceptance and CBT-based tools for living with sensations.
- Untangling shame — this is not your fault and not a moral issue.
- Helping you and a partner talk about it and keep intimacy on your terms.
- Coordinating with your medical team so nothing falls through the cracks.
Frequently asked questions
Is PGAD the same as being hypersexual?
No. The arousal is unwanted and usually unrelated to desire. Many people find it distressing rather than pleasurable.
How common is it?
No one knows exactly. It is likely under-reported because people feel embarrassed or have been dismissed.
Can men or nonbinary people have PGAD?
Most published research involves women, but people of any gender can experience persistent, unwanted genital arousal sensations. You deserve the same care.
Can therapy cure PGAD?
Therapy isn't a standalone cure. It reduces distress and improves coping alongside medical evaluation and treatment, which together give you the best chance of relief.
Can I do sessions online?
Yes, by secure video from a state where your clinician is licensed. Many people with PGAD find sitting in a waiting room uncomfortable, so home can be easier.
Who on your team would I see?
You don't need to pick. Book a free consultation and our intake team matches you with a clinician licensed where you live and who works with this concern.
Keep reading
- Women's sexual health — Desire, arousal, pain and orgasm concerns.
- Sexual pain disorders therapy
- Pelvic floor physical therapy and sex therapy
- Dyspareunia vs. vaginismus vs. vulvodynia
- Antidepressants and sex drive
- Sexual shame
Also on this site
- Referral partners — Pelvic floor PTs and medical providers we work alongside.
- Meet the team — See who is taking new clients.
- Book a free consultation — Fifteen minutes, no pressure to continue.
Clinical resources this page draws on
- ISSWSH consensus on PGAD/GPD (Goldstein et al., 2021) — Journal of Sexual Medicine — International expert consensus on naming, causes and a care pathway.
- 988 Suicide & Crisis Lifeline — Call or text 988 in the US, any time.
- AASECT — Find a certified sex therapist — Useful if you live outside the states our team serves.
Next step
Not sure where to start? Take the free 6-question assessment, or book a 15-minute consultation.