Advocacy and Research

In Memory of Gretchen Molannen

By Riva Preil

On December 1, 2012, Gretchen Molannen ended her life tragically after years of suffering from Persistent Genital Arousal Disorder (PGAD). PGAD is a disorder where the individual experiences prolonged and intense periods of genital arousal. The symptoms may be relieved temporarily by stimulating an orgasm, however the symptoms usually return within several hours. Certain situations may trigger the symptoms, including riding in a car or cell phone vibration. For many, the discomfort associated with increased arousal progresses to pain, and those who suffer from PGAD often refrain from intercourse due to pain and/or shame. In addition, this condition interferes with many activities of daily living, such as attending to work related tasks and interpersonal relationships.

Unfortunately, researchers have limited information regarding the cause and treatment for PGAD. To date, it seems that there is a connection between PGAD and sensory nerve dysfunction. PGAD is also associated with pudendal nerve entrapments; nerve blocks have been used to treat PGAD with limited success. In some cases, PGAD may be related to pelvic arterial-venous malformation, in which case surgical intervention is indicated to correct the underlying issue. Antidepressants, antiandrogenic medications, and anesthetic gels have been prescribed to help alleviate the discomfort. However, “one of the problems with PGAD is a lack of knowledge. Many doctors don’t know about it and it’s not even recognized by the medical community as an official condition. Therefore any procedures that may potentially reduce the problems are not covered by insurance because there’s no code for PGAD. What’s more, it’s unknown how many women have the condition since many choose not to talk about it out of embarrassment†(quoted from the Ryan Jaslow’s article in CBS News; see link above). Furthermore, people experiencing PGAD may very likely benefit from pelvic floor physical therapy. PGAD can increase sensory and motor nerve sensitivity, and it can create pelvic floor muscle tightness. This tightness can pull on the genital region and increase the symptoms of arousal and pain. Furthermore, the tightness can restrict and irritate the nerves in the pelvic region which results in hypersensitivity to the surrounding organs and in the general region. Pelvic floor physical therapy can help treat the musculoskeletal and nerve restrictions associate with PGAD.

Gretchen was courageous by sharing her story with the world. May her tragic story raise public awareness regarding the debilitating nature of this terrible disease thus spurring further research into appropriate treatment methods. May she rest in peace.

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