Persistent Genital Arousal Disorder
Persistent Genital Arousal Disorder
This course includes
The instructors
Overview
Persistent genital arousal disorder (PGAD) is characterized by symptoms of physiological sexual arousal in the absence of feelings of subjective sexual arousal. PGAD is a highly distressing condition that remains widely misunderstood.
In this online course, Dr. Caroline Pukall explores key topics related to PGAD, including its prevalence, diagnostic considerations, novel research findings, and evidence-informed approaches to assessment and management. The condition challenges three assumptions commonly held among clinicians, including the beliefs that physiological and subjective arousal work together, that arousal is inherently pleasurable, and that more arousal is better. As a result, individuals with PGAD often consult several health care providers before accessing appropriate support, and many are dismissed or misdiagnosed along their care journey.
Learning Objectives
By the end of this course, participants will be able to:
- Identify the core clinical features of PGAD, including symptom duration, response to orgasm, and associated distress.
- Identify proposed contributing factors to PGAD.
- Recognize the most commonly reported initial triggers of PGAD symptoms.
- Structure a comprehensive assessment covering symptom characteristics, psychosocial correlates, impact, sexuality, and medical, musculoskeletal, and trauma history.
- Discuss current treatment options, reported outcomes, and the case for a multidisciplinary approach that includes pelvic floor physiotherapy, psychological therapies, and medical care.
Audience
This course is designed for healthcare and rehabilitation professionals who assess or treat pelvic and sexual health concerns, including:
- Physiotherapists
- Occupational Therapists
- Psychologists
- Physicians
- Healthcare professionals supporting people with pelvic pain or sexual health conditions
Why This Course Matters
PGAD is estimated to affect about 1% of people, yet it remains largely absent from clinical training and everyday practice. As a result, many individuals spend months or years moving between providers before receiving a diagnosis, and some never receive one at all. Along their care journey, their symptoms may be dismissed or attributed solely to psychological causes, which adds to the distress, shame, and fear of judgement they already experience.
The research presented in this course highlights a clear opportunity, showing that when clinicians are knowledgeable, communicate well, and validate the patient's experience, patients report lower levels of depression, anxiety, sexual distress, and symptom severity. Recognizing PGAD and responding with informed, compassionate care can make a meaningful difference for patients who have often felt unheard.
Speaker Bio: Dr. Caroline Pukall, PhD, CPsych
Dr. Caroline Pukall, PhD, CPsych, is a Tier 1 Canada Research Chair in Sexual Health and a Professor in the Department of Psychology at Queen's University, where she directs the Sexual Health Research Laboratory (SexLab) and the Sex and Relationship Therapy Service. She received her PhD in Clinical Psychology from McGill University. Her research focuses on genitopelvic dysesthesias, including vulvodynia and persistent genital arousal disorder, as well as sexual arousal and other aspects of sexual wellbeing, with an emphasis on increasing the representation of sexually and gender-diverse people in sexual health research.
Caroline is passionate about using multiple methodologies in her research and she has investigated numerous aspects of sexuality using brain imaging, psychophysics, psychophysiology, and blood flow imaging, relating the findings of these methods to a variety of self-report measures. Her research has been funded by organizations including the Canadian Institutes of Health Research and the National Vulvodynia Association. This course is offered in partnership with Pelvic Health Solutions.
Related Learning
Courses
- Five Things I've Learned About Assessing and Treating Vulvodynia
- Trauma Informed Pelvic Health - An OT Perspective
- Sex & Pain Postpartum for Physiotherapists
Blogs
The instructors
Pelvic Health Solutions (PHS) is an evidence-based teaching company that aims to educate and empower physiotherapists, healthcare professionals, and everyday people about pelvic health.
PHS was founded in 2010 out of the need to develop pelvic health resources in Ontario at a time when it was an under-serviced health concern. PHS provides continuing education courses, mentoring, and clinical resources for a variety of practitioners with the goal of equipping them to deliver evidence-based, biopsychosocial assessment and treatment of pelvic health problems in our province and abroad.
Our company also exists as a way to connect people experiencing pelvic health concerns to pelvic health physiotherapists in their area. PHS has ultimately blossomed into a community of curious people who are committed to providing hope and healing to those who suffer from pelvic health issues.
Material included in this course
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Course Materials
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Welcome and Slides
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Assumptions
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What is Persistent Genital Arousal Disorder
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Symptoms
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Treating PGAD
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Questions
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Feedback
What is persistent genital arousal disorder (PGAD)?
PGAD is characterized by persistent, intrusive, unwanted, and distressing sensations of genital arousal that do not remit after orgasm and occur in the absence of sexual desire or subjective arousal. Symptoms can last hours or days and may be triggered by sexual or nonsexual stimuli, or appear with no clear trigger.
How common is PGAD?
Research presented in this course estimates PGAD affects about 1% of people, similar to the prevalence of schizophrenia. It occurs in women, men, and non-binary people, yet remains largely unknown in clinical practice.
Why is PGAD often misdiagnosed?
Because arousal and desire are disconnected in PGAD, the behaviours patients use to cope can be misread. Reduced sexual activity may be mistaken for low desire, while increased sexual activity may be mistaken for hypersexuality.
What role does pelvic floor physiotherapy play in PGAD?
Pelvic floor physiotherapy is one component of the multidisciplinary approach discussed in this course, alongside psychological therapies, medications, and other medical options. The course also covers when to refer to a pelvic floor physiotherapist and psychologist.
Who should take this PGAD course?
It is designed for physiotherapists, psychologists, physicians, and other practitioners who assess or treat pelvic, genital, or sexual health concerns and want to recognize and support patients with PGAD