If you suffer from persistent genital arousal disorder, you’ll experience feelings of sexual arousal in your pelvic area that do not stop. Despite sexual or non-sexual triggers, including an erotic video or masturbation, the sensation does not go away.
PGAD is often experienced by women during menopause, but it can also affect post-menopausal women who have been treated with hormone therapy. It may also occur due to a psychological cause such as depression or trauma.
Estradiol
Estradiol (E2) is a natural female hormone that plays an important role in maintaining the normal balance of reproductive hormones. It is converted to estrogen conjugates in the liver, including estrone and estriol, which are excreted via the kidneys. The metabolites are also excreted into the bile, and some are reabsorbed in the enterohepatic circulation. The levels of these metabolites in the body vary throughout the menstrual cycle.
Estrogen regulates ovarian follicles, and its level is highest in premenopausal women. It also has anti-inflammatory effects and promotes bone formation and muscle growth. After menopause, a woman’s ovaries stop producing estradiol. Estrogen replacement therapy can help relieve menopausal symptoms.
In one study, a correlation between salivary estradiol levels and the peak of women’s sexual desire during the ovulatory phase of the menstrual cycle was found. This finding suggests that the decrease in estrogen during menopause may contribute to genital arousal disorders, such as decreased sexual desire, mood disorders before and during sexual intercourse and diminished sexual responsiveness or the inability to reach an orgasm.
Women who are prescribed estrogen should tell their doctors if they have any of the following symptoms while taking it. These include a sudden, severe headache; vision changes, such as double vision; or chest pain or heaviness. They should also tell their doctor if they are taking any other medications, including over-the-counter medicines, vitamins, and herbal products.
Testosterone
Testosterone is an androgen, or sex hormone, produced in the gonads (the testes in men and the ovaries in women). Along with dihydrotestosterone, testosterone is responsible for sperm development during puberty. It also promotes the growth of pubic and body hair, enlargement of the penis and external genitalia, muscle and bone formation and is associated with aggressive behaviour and sex drive in both men and women. It is present at higher levels in males than females.
It is the only sex hormone that can increase sexual desire in both women and men. Low levels of testosterone can cause erectile dysfunction in men and limit orgasm in women. A testosterone deficiency is often diagnosed by a physical exam or blood work. Testosterone is made in the testicles, and in lower quantities in the adrenal glands that sit on top of each kidney.
Researchers have not fully understood how testosterone increases libido, although they believe that it affects the way the brain responds to sexual stimuli. It is also important for the normal function of the ovaries in women, and can help prevent menopause symptoms by keeping estrogens at their lowest level during the periovulatory phase of the cycle. It is thought that the brain reacts to ovulation cues by changing the central neurophysiological functioning of particular neuronal pathways, and that this increases sympathetic reactivity.
Luteinizing Hormone
During the first part of the menstrual cycle, luteinizing hormone stimulates follicles in the ovaries to produce an egg, or oocyte. It also causes the lining of the uterus to thicken. Once a mature oocyte is released, the corpus luteum produces progesterone to support pregnancy if fertilization occurs.
Unlike estrogen, which is produced in the ovaries, luteinizing hormone is made in the anterior pituitary gland. Its release is regulated by a system known as the hypothalamic-pituitary-gonadal axis. Kisspeptin in the hypothalamus binds to receptors on the pituitary gland, stimulating the production and secretion of luteinising hormone and follicle-stimulating hormone (FSH). LH binds to cells in the testes or ovaries to trigger the release of testosterone or oocytes, respectively.
LH levels are very variable and fluctuate during puberty and pregnancy, when a woman’s body is preparing for a new life. It’s common to measure a woman’s LH level along with her levels of estradiol and testosterone, to get a more complete picture of her reproductive health.
Women’s libido usually peaks just before she ovulates, and drops again after ovulation. For this reason, ovulation predictor kits measure a woman’s LH to help determine when she is most likely to ovulate. This information is particularly useful for women who want to try to become pregnant. A low level of LH can signal that the hypothalamus isn’t sending enough gonadotrophin-releasing hormone from the pituitary gland to support normal testicular or ovarian function.
Progesterone
The ovaries, adrenal glands and fat cells produce the female sex hormones estrogen and progesterone. They help control the menstrual cycle and prepare the uterus for pregnancy once ovulation begins. Progesterone also helps prevent early uterine contractions and supports a healthy pregnancy when it does occur.
The levels of both estrogen and progesterone rise during the luteal phase of the menstrual cycle, when they help thicken the uterine lining and protect it from bacteria and sperm. During pregnancy, the levels of both hormones are higher still. They continue to support a pregnancy by providing the body with the nutrients and oxygen needed for the fetus. They also cause milk ducts to open and drain into the breasts.
Medications can be used to replace the natural progesterone produced in the body. These medications are called progestins and include medroxyprogesterone acetate (MPA), cyproterone acetate (CA), and levonorgestrel acetate (LNG). These drugs are usually given in combination with estrogen as part of hormone replacement therapy to treat symptoms associated with menopause. They are also included in certain oral contraceptives to prevent pregnancy.
Intravaginal prasterone, a prescription medication made from dehydroepiandrosterone, can reduce vaginal dryness and dyspareunia and improve orgasm and sexual interest in premenopausal women. It is taken in small doses daily for up to 12 days before an expected period starts. This treatment should only be used with a doctor’s supervision, and it is not recommended for anyone who has had ovarian cysts, ovarian cancer or a molar pregnancy.
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