Document Detail


Persistent genital arousal disorder: a case report in a woman with lifelong PGAD where serendipitous administration of varenicline tartrate resulted in symptomatic improvement.
MedLine Citation:
PMID:  19228278     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Persistent genital arousal disorder (PGAD) in women is associated with feelings of persistent, spontaneous, intrusive, unrelenting, and unwanted physical arousal in the absence of conscious thoughts of sexual desire or sexual interest. AIM: To report the case of a 49-year-old woman with lifelong PGAD who was recently prescribed varenicline for smoking cessation and who subsequently experienced amelioration of PGAD symptoms. METHODS: Patient self-report and literature review. Written consent was obtained from the patient. RESULTS: Abatement of lifelong PGAD symptoms occurred within approximately two weeks each time varenicline treatment was initiated. PGAD symptoms returned in approximately 2 weeks each time treatment was suspended. CONCLUSIONS: Varenicline is a partial agonist of the alpha2beta4 subtype of nicotinic cholinergic receptor. Its unique pharmacological action stimulates a small amount of brain dopamine release while antagonizing the ability of nicotine to stimulate much larger dopamine release. Genital sexual arousal is controlled in part by the action of hypothalamic and limbic dopamine systems. Based on the mechanism of action of varenicline and the observation of its effectiveness in this case, we hypothesize that: (i) central hyperactive dopamine release is an important component in the pathophysiology of PGAD in this patient; and (ii) use of varenicline resulted in lowering of this hyperstimulated central dopamine release. Objective testing of varenicline's safety and efficacy in the treatment of other women with PGAD is suggested.
Authors:
Joanna B Korda; James G Pfaus; Irwin Goldstein
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-02-18
Journal Detail:
Title:  The journal of sexual medicine     Volume:  6     ISSN:  1743-6109     ISO Abbreviation:  J Sex Med     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-20     Completed Date:  2009-09-10     Revised Date:  2010-04-08    
Medline Journal Info:
Nlm Unique ID:  101230693     Medline TA:  J Sex Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1479-86     Citation Subset:  IM    
Affiliation:
Department of Psychology, San Diego State University, San Diego, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Benzazepines / administration & dosage*
Central Nervous System Agents / administration & dosage*
Female
Humans
Middle Aged
Quinoxalines / administration & dosage*
Receptors, Dopamine / drug effects
Receptors, Nicotinic / drug effects
Sexual Dysfunctions, Psychological / drug therapy*
Smoking Cessation / methods
Chemical
Reg. No./Substance:
0/Benzazepines; 0/Central Nervous System Agents; 0/Quinoxalines; 0/Receptors, Dopamine; 0/Receptors, Nicotinic; 0/varenicline
Comments/Corrections
Erratum In:
J Sex Med. 2009 Nov;6(11):3225

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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