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Restless Genital Syndrome and Restless Leg Syndrome

Restless Genital Syndrome and Restless Leg SyndromeRestless genital syndrome (RGS) is a rare but bothersome condition with unknown causes, which can make it difficult to treat. However, a recent case study published by JAMA Neurology suggests that there might be a connection between RGS and restless leg syndrome (RLS) and that a dopamine agonist could provide relief.

[Note: Restless genital syndrome is sometimes called persistent genital arousal disorder (PGAD) or persistent sexual arousal syndrome (PSAS).]

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Connection between restless genital syndrome and restless leg syndrome? Potential relief? Click here to tweet.

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What is RGS?

Women with RGS feel genital arousal that is not associated with sexual desire or sexual activity. They might feel tingling in the clitoris, throbbing or pain in the genitals, and vaginal contractions. Some women with RGS have spontaneous orgasms. Symptoms might last for hours or even days.

RGS can cause a great deal of distress. Patients do not want to feel this way. They often feel ashamed, anxious, and depressed. Reaching orgasm usually doesn’t help for long. In fact, women may start to avoid sex because they associate orgasm with attempts to relieve pain.

Symptoms may worsen during times of stress or anxiety, so sometimes cognitive behavioral therapy or medication can help. Ice or anesthetizing medications may be applied to the area to dull the sensations. In some cases, pelvic floor physical therapy, electroconvulsive therapy, or surgery are beneficial.

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Recent case study

The JAMA Neurology case study describes a 65-year-old woman with Parkinson’s disease who had been having symptoms of RGS for three years. Most of the time, she had symptoms in the evening, when she was sitting or lying down. Specialists had been unable to pinpoint the cause or provide her with relief.

While she did not have restless legs, clinicians noted that her RGS worsened at night. Examining the professional literature, they found studies suggesting a possible link between RGS and RLS. With that in mind, they prescribed a low dose of a dopamine agonist, a drug that may be used to treat Parkinson’s and RLS.

The dopamine agonist worked and the woman’s RGS symptoms improved.

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Implications for Practice

Should clinicians automatically prescribe a dopamine agonist for patients with RGS? Not necessarily. A patient’s complete medical history needs to be considered to determine if this treatment is appropriate.

However, this report builds the case that RGS and RLS are related conditions – an idea clinicians might note when treating women with RGS.


Print this article or view it as a PDF file here: Restless Genital Syndrome and Restless Leg Syndrome


Resources

JAMA Neurology

Aquino, Camila C., MD, MSc, et al.

“Restless Genital Syndrome in Parkinson Disease”

(Abstract. Published online: October 6, 2014)

http://archneur.jamanetwork.com/article.aspx?articleid=1910851

International Society for Sexual Medicine

“How is Persistent Genital Arousal Disorder (PGAD) treated?”

http://www.issm.info/search-results/search&keywords=PGAD/

“What causes Persistent Genital Arousal Disorder (PGAD)?”

http://www.issm.info/education-for-all/sexual-health-qa/what-causes-persistent-genital-arousal-disorder-pgad/

“What is Persistent Genital Arousal Disorder (PGAD)?”

http://www.issm.info/education-for-all/sexual-health-qa/what-is-persistent-genital-arousal-disorder-PGAD/

Medscape Medical News

Anderson, Pauline

“Restless Genital Syndrome a Variant of Restless Legs?”

(November 4, 2014)

http://www.medscape.com/viewarticle/834352

Psychology Today

Borigini, Mark

“Restless Genital Syndrome: The Intersection of Chronic Pain and Chronic Arousal”

(June 29, 2011)

http://www.psychologytoday.com/blog/overcoming-pain/201106/restless-genital-syndrome-the-intersection-chronic-pain-and-chronic-arou