PGAD after a nerve block

[Balenul]

Pgad - Persistent Genital Arousal Disorder
I think Golstein , Kruger or others will find a treatment for Pgad no matter the cause ( meds induced , stress , pudendal , spine problems etc ) but will take more time.I see a lot of new studies done 2022 , 2023 and now i read a 2023 study where they said Pgad affect males in same percent as womens....so they can t ignore this horrible disease anymore....so many suffer from this , and the percentage is higher than what they thought many years ago.

[Aristocat]

Hi Balenul,

First of all, I would like to say again that everything I write is my personal opinion, because it does not always agree with medical opinions.
Before I go into PGAD in more detail, I would like to write something that I found on my journey through literature - especially trauma literature.
At some point I ended up with Wilhelm Reich. He was a student of Sigmund Freud and lived from 1897 - 1957. Like all psychoanalyts he dealt with sexuality, was the first to deal with body therapy and the first to have the idea that the autonomous nervous system plays a major role.
In one of his books from 1927, Reich describes cases of female patients. Some of them showed typical PGAD symptoms, which are now part of the diagnostic criteria. Reich also describes the life stories of the patients. They were all horribly traumatized with multiple traumas. Reich diagnosed them with nymphomania.......there was no other idea in these times.

Why am I writing this?
I consider PGAD to be a trauma-related syndrome. Traumas can be manifold. It's not always the big event that throws us off our way. Everything we experience is stored in our nervous system, which can then lead to a wide variety of reactions at some point.
I think PGAD is a very old syndrome, primarily in women, but also in men. Since the use of psychotropic drugs, which can lead to sexual dysfunction, this syndrome has become more and more public. Furthermore today people speak more openly about sexuality than 100 years ago. And.....it was a woman, a US psychologist, Sandra Leiblum, who first described the syndrome and who said that the women are not nymphomanic.

But now to today's PGAD
The central and the autonomic nervous systems are influenced by both, trauma and psychotropic drugs. The central nervous system sends neurotransmitters to the brain, to say it in a very simply way. That's why medicine believes that they are able to influence the neurotransmitter Serotonin and it could resolve depression. It seems this oppinion didn't go well. Firstly, PGAD cases and other sexual dysfunctions seem to be increasing, secondly, the serotonin hypothesis has been scientifically refuted, it is nonsense. I estimate that on the German PGAD forum 80% of all PGAD cases took psychotropic drugs or suffered from PGAD after stopping them. Many patients report depression/anxiety disorders. As far as I know, in the meantime it is reported in the instructions that sexuality can be affected.This kind of side effect is absolutly not taken seriously by medicine. If they did, they took these pills from the market.... at once. Because no one who doesn't experience these feelings can imagine what it means.
If you want to learn more about psychotrpic drugs and “mental disorders” have a look at “madinamerica.com”, a very serious and enlightening website. Or do read the books from Prof. Peter Gotzsche.
Now I come to the autonomous nervous system. In the meantime in trauma research the “fight or flight – freeze” conditon is well known.
If a person is exposed to constant stress, this condition can arise in the autonomous nervous system. But it can also be caused by accidents, medical operations and other direct negative physical experiences.
The “fight or flight” state means for the body: concentration, tensing the body, accelerating breathing, clenching the teeth, adjusting digestion.
When this state runs automatically, the body is overwhelmed and goes into "freeze". This can be depression, CFS (Chronic Fatigue Syndrome), polyneuropathy due to the tensions and much more.
Of course, the tensions happen completely unconsciously, as we are not constantly faced with great danger and have to fight or flight.
For me, PGAD is a "fight or flight" state that is conditioned and not so easy to stop. Something has happened in the brain, in the Amygdala??, that runs in continuous mode. This would also explain why SSRIs, which are supposed to stimulate the person and eliminate depression, seem to do "too much" and cause overexcitation or, in the case of PSSD (Post SSRI Sexual Dysfunction), total numbness of the genitals and the feelings.

Yes, the pelvic floor plays a big role. But human beings have three diaphragms: pelvic floor, diaphragm and throat, and all three are constantly interacting with each other.
If I am constantly in “fight or flight”, I (unconsciously) tense the pelvic floor, hold my breathing or only breathe in the upper part of my body and clench my teeth. All three diaphragms are therefore under maximum tension. That's why I wrote that conscious, correct breathing is so important. This needs to be practiced, if possible with a therapist.

By the way, Prof. Krüger works with psychotropic drugs, as far as I know. I have never spoken to him personally. On this forum a German woman wrote she could manage the feelings with several psychotropic drugs. One of it is Duloxetin viewtopic.php?t=9774. Another woman I know personally had no success, in the opposite, the feelings grow up by this medication. It seems, medication and PGAD is a gambling.

Of course you can try a Botox injection into the pelvis. Nevertheless perhaps you also look for a pelvis therapist to learn to relax it more and more. Today those therapists know very well that the jaw has to be treated too.

I wish you all best and hope that the injection gives you a bit relief.
Aristocat

[Balenul]

Thank you .Your knowledge is very big and i also read alot since Romania is a joke.Pgad is not so new to me i remembered i had this sometimes when i was in huge stres...but was rare and 1 ejaculatiom was enough.If i think now that was Pgad , a very small one , no pills , pelvic floor back then.Now after a pituitary apoplexy my autonomic nervous system is not so good anymore and after a rectal prolapse and diabet insipidus imo Pgad was hard to avoid even without Zoloft stopping.Stress / anxiety / traumas can give Pgad for life as you said.This stress also make pelvic floor super tight and press on pudendal nerve and branches....imo i need multifactorial treatment.Yes Dr Kruger is a fan of Duloxetine ( make my Pgad worse also )....imo curing Pgad that is not from a pudendal problem or a spine problem ( a disk that press on cauda equina or pudendal roots etc ) is about luck.You try to stop stress , anxiety , and stop all meds and hope you recover some did and weeks some in years and some never or you try other meds and you pray one will work.I need to find the right med for me i feel could help my Pgad greatly , i also hope genital block will allow me to not feel Pgad anymore a period even if maybe in my case the bigger problems is the brain for Pgad....for urinary etc 100 % is more pelvic floor and botox i think will help , i hope will improve Pgad also since i repeat i think a part is from there also but as you said at least in my case is more from huge stress / anxiety and Zoloft stopping .Sometimes i have no Pgad for hours and if i get angry Bam huge one ane i must masturbate...Also my Ocd don t help me at all.I agree with all you said and i would like to meet Kruger and i hope i will Is a pleasure to talk with someoane like you i hope we can talk more

About what you said here : That's why medicine believes that they are able to influence the neurotransmitter Serotonin and it could resolve depression. It seems this oppinion didn't go well.

I agree here but not tottaly , but some got depression ameliorated with Ssri or Snri or Anafranil ( the strongest serotonine drug ) but some got worse and suicided or had to take them for life....we need new meds , new studyes etc for Depression , Pgad etc and here my doctor agree ( i hardly found a smary psyhiatrist with open mind ).
What i think plays a factor in Pgad caused by Ssri stopping is dopamine / serotonine imbalance.Is a theory from Goldstein from SanDiego : the study here with many possible causes.

https://www.sciencedirect.com/science/a ... via%3Dihub

In my case if i get angry Pgad can start instantly sometimes or stress so dopamine / serot inbalance prolly or my pelvic floor don t have time to give me this instant Pgad.yes they play a part prolly and i repeat i need multifactorial treatment but i agree with you Stress / anxiety / trauma can give Pgad with no meds , no pudendal problems etc...And sadly prolly they will get cure with another med also.

PS : i repeat this phrase is very interesting :

However, in a TV program he said that in his opinion the neurotransmitters in the spinal cord are the problem. This seems logical if the problems start sometimes after taking SSRIs.

I hope i will meet him and talk with him about it.You have more details about this Tv show or an article i would love to read it.Imo is a big possibily , since let s take my case i had some Pgad before all my problems but small...after i had Ocd pills and stopped them instantly ( next day bam all dose over ) even Zoloft , Paxil , Duloxetine etc and my Pgad remained same very very rare.After 2 years of huge stress , pituitary apolexy and autonomic problems also super tight pelvic floor ( urinary problems , rectal pressure etc )...when i stopped Zoloft in 3 weeks bam Pgad ( and now i stopped it slowly , guess what first time appeared when i had a Ocd panic mode )....

But i repeat , what he said there prolly could give Pgad to super healty people ( but for sure they had stress / traumas ) or taked Ssri etc or similar meds.Question is why they have that zone sensitive ? Maybe stress / anxiety / traumas made it like this ( that sensitive zone ) and also stress etc started Pgad...or maybe they are born like this and have a preddsposition for this.Again a complicated topic i would love to talk with him...Anyway this stupid meds can cure Pgad or give it , but all cases are different ( i don t talk about physical here...but meds can prolly improve even pure physical Pgad ).I wonder if a spinal neuromodulator or Drg or Transcranian stimulation could help Pgad no matter the cause.

I repeat your knowledge is impressive.Hope we chat again.Btw Ocd plays a big part in Pgad also at least in my case

Sry for mistakes in writting i am very tirer and english is not my main language.

[Balenul]

Also Aristrocrat how you function with your Pgad...how is Pgad for you ? Constant big / medium / small....part or day good and part bad ? In waves / flares ? For me is not constant but when is up is horrible.For how many years you suffer and you think a cure will be find at one point ? Sadly not time to read your papers this day.....monday i have procedure in Poland and today i fly etc.What you do to make it better.

[Summer]

Supprimer

[sadie]

Kammulka

Hi can you look at your medical records and see what kind of steroid they used in you nerve block ..

was it a pudendal nerve block ,

if not, what kind of nerve block was it?

Ty and let no stone be unturned , and please question authority .. knowledge is power n peace . Hugs Sadie

[sadie]

Balenul and Kummulka,

I posted this link on another area of this forum but copied the link to send to you so that you can see that you are not alone and there are those that 100% feel your pain.

Kummulka i sent you post to ask what kind of steroid they used in your block as that really matters. Of course, they may not have even used a steroid, I just thought getting it in writing from your medical records notes may be better than just asking the dr. what was used.

..theories we hear about how pgad starts are a dime a dozen, so be careful...i cut this sm area on, RELATIONSHIP BETWEEN PGAD AND ANTIDEPRESSANTS from a paper i wrote a while back.

hope this helps.

PGAD POST - Copy.pdf

SADIE TIMELINE

(425.1 KiB) Downloaded 79 times

RELATIONSHIP BETWEEN PGAD AND ANTIDEPRESSANTS

The following two posts on HOPE address the relationship between antidepressants and PGAD. The first post, “Re: PGAD - persistent genital arousal disorder” (November 22, 2017), involves a patient who may get a psychiatric diagnosis if her PGAD symptoms abate after taking an antidepressant. Referring to her doctor she writes, “He thinks that this is a psychological issue and he prescribed some antidepressant.” Antidepressants are often prescribed to PN and PGAD patients to derail symptoms. Hence, the doctor’s opinion that her PGAD is psychological may be in his opinion justified, if the symptoms disappear after she takes the prescription. When in fact, the Antidepressant is stopping the PGAD signals from going to her brain and her symptoms are not psychosomatic.

Medical papers and posts suggest the rapid discontinuance of antidepressants can cause PGAD
In the second post, “Re: PGAD - persistent genital arousal disorder. Please help m”
(August 9, 2017), the theory about rapid antidepressant discontinuance causing PGAD is in part questioned. There can be instances where medications or the rapid discontinuance of medications can manifest in a myriad of ways. However, in a forum post an alternative theory is proposed, “If a woman is on an antidepressant, and while on the antidepressant for say 'situational depression" or to stop pain (burning or static etc.), and then she injures the pudendal nerve or further injures an already damaged Pudendal nerve, PGAD may develop. However, because she is on an antidepressant, she may be unaware of the PGAD (because the antidepressants are blocking the PGAD signals to her brain). Then when she comes off the antidepressants, because she no longer feels depressed and her situation has changed, she than feels for the first time the (PGAD) symptoms that were being masked by the medications and thinks that the cause of her PGAD is because she has stopped the medication. Likewise, many patients on Lyrica feel this medication causes weight gain and it may be true. However, when I spoke with several pharmacist to see if there were any ingredients in Lyrica to cause weigh gain, the answer was 'none.” So the correlation between weigh gain and Lyrica could be made because most patients on Lyrica are taking it for pain, and those of us in pain do not exercise as we did before taking the medication, which could actual be the cause of the weight gain. So many times it may look like a drug is causing a side effect when it is not.”

With a larger pool of women to study via the internet, newer scientific research is needed on the subject of “PGAD and antidepressants.” In the past the “‘PGAD and antidepressant” link was attributed to a result of a rapid discontinuance of antidepressants. Now when the topic is discussed on forums, patients are claiming slowly titrating, as opposed to a rapid withdrawal, is also causing PGAD. “Persistent Genital Arousal Disorder in Women: Case Reports of Association with Anti-Depressant Usage and Withdrawal” by, Leiblum and D. Goldmeier discusses five patients from a survey of three hundred and sixty-four. Only five patients from the survey pointed to the onset of PGAD, to the discontinuance of SSRI’s. In three of the five cases the women reported gradually titrating off their antidepressant. Out of these three cases, one woman’s PGAD symptoms lasted three to four weeks after discontinuance then ceased, never to return. The fourth case did not report how the patient titrated off antidepressants, and the fifth patient reported PGAD symptoms only while on antidepressants.
One theory for the link between PGAD and anti-depressants suggests that withdrawal can increase levels of aerial natriuretic peptide which includes cyclic guanosine monophosphate causing local vulval vasodilation. Dr. Leiblum et al concludes writing, “While SSRI usage appears to be implicated in these cases, it is by no means, responsible for the vast majority of cases of PGAD since the presumptive triggers are so varied. Nevertheless, antidepressant withdrawal, in the patients we describe, appears to be anecdotally related to the onset of the PGAD. More commonly, other clinicians (Csoka & Shipko, 2006) have described hypoactive sexual desire in the withdrawal phase from anti-depressants.” Adding, that during this post discontinuance a woman is likely to become more acutely aware of genital sensations, as she returns to a base line of desire and arousal.

xoxo sadie