Martín-Vivar María, Villena-Moya Alejandro, Mestre-Bach Gemma, Hurtado-Murillo Felipe, Chiclana-Actis Carlos
Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, Madrid, Spain; Universidad Francisco de Vitoria, Madrid, Spain.
Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, Madrid, Spain.
J Sex Med. 2022 Jun;19(6):961-974. doi: 10.1016/j.jsxm.2022.03.220. Epub 2022 Apr 6.
Persistent genital arousal disorder (PGAD) is characterized by elevated discomfort associated with persistent genital arousal in the absence of sexual desire.
To perform a scoping review of the proposed treatments for PGAD and their efficacy.
A scoping review was carried out (PRISMA-Scr) that included articles on PGAD as the main disorder, only in women, which explained, in detail, the treatment and its efficacy, was empirical, was written in English and Spanish. No prior filtering by years was performed.
Three different effective treatments were found (Physical therapies, pharmacological therapies, and psychotherapeutics in combination with other therapies).
Thirty-eight articles were selected. From physical therapies, treatments using neuromodulation, transcutaneous electrical stimulation, Botox, surgery, electroconvulsive therapy, manual therapy, pelvic floor therapy, dietary changes, and transcranial magnetic stimulation showed effectiveness. Using the pharmacological approach, paroxetine, duloxetine, pramipexole, ropinirole, and clonazepam treatments were effective. Psychotherapy treatments showed effectiveness only in combination with other types of treatments, specifically a combination of cognitive-behavioral strategies with pharmacological treatment.
Pharmacological treatment, specifically SSRIs, have proven to be the therapy of choice for different subtypes of patients.
This study analyzed treatment effectiveness with different approaches and took into consideration those articles where psychotherapy was used as a combination treatment with pharmacological and physical therapy. The main limitation is that it was focused exclusively on women, and the results cannot be generalized to include men.
To date, a combination of pharmacological interventions with physical therapy and, in some occasions, with psychological therapy is main strategy followed to accomplish effective treatment of PGAD. Martín-Vivar M, Villena-Moya A, Mestre-Bach G, et al. Treatments for Persistent Genital Arousal Disorder in Women: A Scoping Review. J Sex Med 2022;19:961-974.
持续性性唤起障碍（PGAD）的特征是在无性欲望的情况下，与持续性性唤起相关的不适感加剧。
对PGAD的拟用治疗方法及其疗效进行范围综述。
进行了一项范围综述（PRISMA-Scr），纳入的文章以PGAD作为主要病症，且仅针对女性，详细解释了治疗方法及其疗效，具有实证性，并用英文和西班牙文撰写。未按年份进行预先筛选。
发现了三种不同的有效治疗方法（物理疗法、药物疗法以及心理疗法与其他疗法相结合）。
共筛选出38篇文章。在物理疗法中，使用神经调节、经皮电刺激、肉毒杆菌毒素、手术、电休克疗法、手法治疗、盆底治疗、饮食改变和经颅磁刺激的治疗方法显示出有效性。在药物治疗方面，帕罗西汀、度洛西汀、普拉克索、罗匹尼罗和氯硝西泮的治疗有效。心理治疗仅与其他类型的治疗相结合时才显示出有效性，特别是认知行为策略与药物治疗相结合。
药物治疗，特别是选择性5-羟色胺再摄取抑制剂（SSRI），已被证明是不同亚型患者的首选治疗方法。
本研究分析了不同方法的治疗效果，并考虑了将心理治疗与药物和物理治疗联合使用的文章。主要局限性在于它仅关注女性，结果不能推广到男性。
迄今为止，药物干预与物理治疗相结合，在某些情况下与心理治疗相结合，是实现PGAD有效治疗的主要策略。马丁 - 比瓦尔M，维列纳 - 莫亚A，梅斯特雷 - 巴赫G等。女性持续性性唤起障碍的治疗：一项范围综述。《性医学杂志》2022；19：961 - 974。
