After several visits with unrelated complaints, a 16-year-old female patient disclosed symptoms of unwanted genital arousal and was diagnosed with persistent genital arousal disorder (PGAD).
A 16-year-old female patient with history of depression, sexual abuse, and dysmenorrhea insistently requested etonogestrel rod removal. At 2 visits after implant removal, the patient disclosed the reason for her insistence: PGAD symptoms developed after implant insertion, although they worsened with removal. Chart review revealed selective serotonin reuptake inhibitor discontinuation before symptom onset. Normalization of sexual arousal occurred with counseling, selective serotonin reuptake inhibitor treatment, and hormonal contraception.
Summary and Conclusion
This case highlights the importance of clinician recognition of PGAD symptoms, which adolescents might not openly disclose. Clinicians must nonjudgmentally collect medication history and sexual history, including sexual arousal and satisfaction, to make this diagnosis.
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Published online: December 01, 2018
The author indicates no conflicts of interest.
This case was previously presented at the North American Society for Pediatric and Adolescent Gynecology 32nd Annual Clinical and Research Meeting in April 12-14, 2018, in West Palm Beach, Florida.
© 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.