Woman’s ‘uncontrollable orgasmic episodes’ baffles doctors – until a common hormone problem is found to be the cause

Doctors were left baffled by a rare condition that saw a 20-year-old woman experience multiple orgasms several times a day, leaving her constantly sexually aroused.
Far from being pleasurable, the unnamed woman said the disorder caused her intense distress and interfered with her work and social life.
From the age of 14 she also suffered with sharp ‘electric sensations’ in her groin and pelvic contractions resembling orgasms.
Despite multiple treatments, including antidepressants, her symptoms persisted, causing her to believe that her orgasms were being externally manipulated.
When she finally visited a hospital in China desperate to get help, her condition had progressed to the point that she could not get through the initial consultation without suffering an episode.
Neurologists were left clueless after ruling out epilepsy and a host of other neurological disorders through ECG monitoring and other tests.
On physical examination, the patients also showed no structural abnormalities that could have been affecting her reproductive organs and triggering feelings of arousal.
Eventually doctors diagnosed her with persistent genital arousal disorder (PGAD) after a course of antipsychotic medication—risperidone and later olanzapine—proved promising.
Far from being pleasurable, the young woman said her orgasmic episodes completely dismantled her work and social life
After a few weeks of treatment, her symptoms began to subside and her delusions improved, enabling her to return to work and resume social commitments.
However, it was observed that when she stopped taking the drugs, her symptoms returned.
The disorder is still widely misunderstood and is thought to affect just one per cent of people leaving in the UK, most of which are women, although experts say the condition is underdiagnosed.
Doctors remain uncertain what cause the complex condition, but it is thought to result from the misfiring of nerves that connect the brain and the genitals.
Whilst there is no specific cure, patients can take various medications that work by suppressing nerve signals, in the hope of easing symptoms.
PGAD symptoms vary widely but commonly include genital pain and discomfort and intense sensations of arousal without sexual desire or stimulation.
Possible physical causes include nerve damage, spinal abnormalities and medication side-effects.
Some studies also suggest that stress and anxiety may worsen symptoms.

Doctors found that her symptoms greatly improved when she started taking anti-psychotic medication, which dampens the dopamine response in the brain
Other schools of thought claim that the disorder is linked to problems with dopamine.
Commonly referred to as the happiness hormone, dopamine is a key neurotransmitter involved in the brain’s pleasure and reward system.
It is thought that excess dopamine may amplify sexual arousal, and could theoretically produce orgasmic episodes and other PGAD symptoms.
It follows that the use of dopamine inhibitors, like risperidone and olanzapine may help lessen these abnormal sexual sensations by dampening the dopamine response.
Doctors led by ing Yan and Dafang Ouyang, affiliated with several national mental health institutions in Beijing, say case studies like these play a vital role in medical advances providing evidence for widely misunderstood disorders.
However, researchers acknowledge that case studies describe one individual, making it difficult to draw conclusions about cause and effect without taking into consideration confounding factors like age, sex and medical history.