Is it possible to have PGAD with vaginitis?

Hello doctor,

I am a healthy 44-year-old female. I have a rather strange thing that I hope you can help me with. About three days ago, I was getting an odd tingling sensation in the area where I think my bladder is. I keep having an orgasm, but I am not thinking about or doing anything sexual. I am just doing ordinary activities. This feeling went away for a day or two, but then last night, it started again and has been happening today. It is uncomfortable and getting on my nerves. I spoke with a doctor this afternoon, and she said she suspects I have a UTI. I have felt like I need to urinate a little more frequently. It does not sting when I go. Urinating does not help this feeling. I am also feeling a burning and tingling sensation in the vaginal area. Since we are under COVID restrictions, I did not see the doctor in person. She had me press on my bladder area, and at that time, it stung and felt like I needed to urinate.

I have had many UTIs, but I have never had this sensation before. The doctor had me do a urine sample and has put me on capsule Macrobid (Nitrofurantoin) two times a day for seven days. I had a pelvic, abdominal ultrasound, and a CT scan a few months back. The results were all normal. Have you ever heard of these types of symptoms before being related to a UTI? Could it be hormonal? I am very concerned that something else is wrong, and this feeling will not stop. I am on tablet Marvelon (I have been on it for many years). I also take tablet Bisoprolol, tablet Dexilant (Dexlansoprazole), and tablet Wellbutrin (Bupropion). I have been on all of these medications for years. I have not changed anything in my diet. I am very worried about this. Please advise.

Thank you.

Thank you doctor,

I have a few questions for you. Please answer. How long will it take to notice a difference if this is a UTI? If this is vaginitis, will capsule Macrobid heal that? If this is not a UTI or vaginitis, what else could be causing these symptoms? I have to be completely honest. Yesterday I felt like I was on the verge of orgasm much of the day from this sensation (especially if I kept worrying about it and focusing on it), and I was not thinking or doing anything sexual. It was incredibly uncomfortable. When I went to bed, I ignored it and went to sleep. I got up this morning, and it is not bothering me as much, but I am also stressed about it and trying not to get it started up. I made the mistake of checking in the internet and saw that some people have persistent genital arousal disorder (PGAD). I am terrified that this may be happening to me. Is this something many people suffer from? Please explain.

Thank you doctor,

I was told I was negative for a UTI. I am becoming very distressed and worried. My symptoms started around two weeks ago but were on and off. They were becoming more persistent, so I thought I might have a UTI and contacted the doctor. As I waited for my UTI results, I also had hormonal symptoms. I have been getting PMS, cramps, nausea, etc. that make me feel like my period is coming, but it is not due. I take capsule Marvelon. Recently, I missed an entire week of pills. After that, I took my pill faithfully and expected to have a difficult period, but I had light this month with few symptoms. As I said, my current symptoms started. When I spoke with my doctor, he said this could be caused by my hormones not being on track and that it may take up to three months for this to resolve when my cycle gets back to normal.

I continue to have these tingling feelings in my lower abdomen and vaginal area. I am embarrassed to say this, but it constantly feels like I am on the verge of orgasm without thinking about doing anything sexual. I have health anxiety and a bad habit of googling my symptoms. I am terrified that I have PGAD (persistent genital arousal disorder). Last year I tested negative for UTI. I saw a urologist who diagnosed me with an overactive bladder. He gave me medication, but it started to resolve independently, so I never took the drug. Could my hormones cause these symptoms? Or could this be an overactive bladder? I am desperate to get this under control, and I am very worried this will last the rest of my life, given what I have read on the internet. I would appreciate any help you can give me.

Thank you

Thank you doctor,

The evening before I saw your response, I noticed that if I worry and focus on my symptoms, they can increase dramatically, but if I tell myself to try to ignore them and think about other things, they tend to settle down quite a bit. I often find they go away when I go to bed if I am not thinking about it. Initially, it would only happen when sitting for a while when this started. I figured it was hormonal (because that is how it felt to me), so I would tell myself it was just my hormones and ignore it, and it would go away. I have terrible health anxiety, so I guess when I started to notice it more and focused on it, I became frightened, googled it, saw people’s comments about PGAD, and that they cannot get rid of their symptoms panicked. That led me to focus on it, and my symptoms became much worse and nearly constant.

After reading your message yesterday, I hope that this could be hormonal (it often feels that way) and that my anxiety and focus on it make it much worse. I know it is not all in my head because I do feel actual symptoms, but yesterday I did my very best to ignore them, stay calm, tell myself it will be fine, wait busy and distracted, and barely felt them. I will continue to take my Marvelon faithfully and consult with my doctor. I have made an appointment with him for a few days after my period to follow up. Thank you again for telling me that my anxiety is making this worse. I think you are correct in that. I am not sure why the stress increases the symptoms, but now I realize it does and needs to divert my attention. Thank you for letting me hope this could be hormonal and not jump to the worst diagnosis without further investigation.

I appreciate your help!

Thank you doctor,

Thank you for your previous responses. I was doing much better over the last week. Whenever I felt any of those sensations, I could ignore them, and they went away. I even forgot I had the issue. I have run into a problem now, though. I finished my Marvelon today, so my period is due either tomorrow or Thursday. I know that is likely affecting my hormones, and I wondered if it might trigger my issue again.

I woke up this morning from a spontaneous orgasm in my sleep, and I was drenched in sweat. These are not uncommon for me. I’ve had them since I was 13 years old, and they generally occur right before my period. So I am not surprised I had one. Although I’m not usually drenched in sweat when I get them. But once it is started, I’m having trouble getting the feeling to go away. I feel like I am on the verge of orgasm again, and it is pretty strong. I don’t know what to do. I hope that if I try to ignore it again as I have been over the last week or so, it will settle down, but it is strong and hard to ignore.

It is stressing me out, which I am sure is not helping either. I don’t know what to do. If it won’t stop, is this considered an emergency? Do I need to go to the emergency room? Or should I call a doctor when our clinic opens? I am not sure if they can do anything for me today or not since my period will be coming soon. I’m assuming it’s hormonal, but I don’t know how to help it. The only thing I can try to do is ignore it. Please help. I would appreciate it if you could get back to me as soon as possible because I don’t know if I need to go to the emergency room or not and if I do, I would prefer to go sooner than later before it gets too busy (it’s 7 am here). Thank you so much.

Thank you doctor,

Thank you for your response. I think my anxiety about the feelings or sensations after the spontaneous orgasm in my sleep was getting bad yesterday, and I panicked. I was so worried about the sensations felt and became frightened. I was afraid they wouldn’t stop. I think it is most likely my hormones as my period is due today or tomorrow. The sensations (not the sweating) lasted most of the day, but the more I focused on them or worried about them, the worse they got. I was able to ignore them at night and sleep without feeling them. I will do my best today to try and ignore them again, but I know that they may be a bit more persistent until my period starts and progresses. I will be seeing my doctor next week so. I will follow up with him. Thank you.