K at Feminists with Female Sexual Dysfunction draws our attention to something that might sound like a joke, at first blush, but is miserable to actually live with: persistent arousal syndrome. It’s been mocked in the media as “restless vagina syndrome,” which trivializes it by equating it with restless leg syndrome(which in turn is only trivial if it’s not robbing you of your sleep, by the way).
Basically, persistent arousal syndrome refers to an almost-constant engorgement or nervous excitement of the genitals. It’s relieved only briefly by orgasms that can occur at the most inconvenient time – even while driving or talking to your mother-in-law. It sounds to me a little bit like what men describe experiencing with blue balls, except that it’s constant, unprovoked, and goes to eleven.
K, who suffers from a different type of pelvic dysfunction, is rightly outraged by articles that treat persistent arousal disorder as an invention of Big Pharma or simply a joke:
Why is this funny?
How is this fake?
Would you actually be comfortable having an orgasm in front of a stranger or in a medical setting, as three of the women in that study are reported to have experienced? What if you were sitting on a bus and the woman next to you started going into an uninhibited orgasm, what would your reaction be? Envy, discomfort, leering, slut-shaming… acceptance?
Why, when nothing else provides long-term relief, would this not merit medical research and possible treatment?
I think one reason people are tempted to crack stupid jokes is because we’ve got such incoherent cultural ideas about women’s sexual responses. We all “know” that women “normally” have great difficulty orgasming; hence all those how-to articles in women’s magazines. (Oddly, there don’t seem to be quite so many how-to articles aimed at women’s male partners.) On the other hand, regular watchers of porn “know” that all you need to do is get a woman naked and she’ll be panting for it, climaxing without any direct stimulation at all!
So which is it?
Whatever the source of the joking, the consequences for women can be dire. A group of Dutch physicians recently reported on an elderly woman who was so desperate that she’d had surgery to remove her clitoris. It didn’t work:
Females despairing of restless genital syndrome (ReGS) may request clitoridectomy for treatment of unwanted genital sensations. … Following a clitoridectomy for spontaneous orgasms, a 77-year-old woman was referred to our clinic for persistent unwanted genital sensations and feelings of imminent orgasm. …
Results. Genital dysesthesias, paresthesias, intolerance (allodynia) for tight clothes, aggravation of symptoms during sitting, restless legs, and overactive bladder were diagnosed. Laboratory assessments, and EEG and MRI of the brain were in agreement with aging, but all results were within the normal range. MRI of the pelvis disclosed varices of the uterus and of the left ovarian vein, and a visible scar in the region of the clitoris. Sensory testing of the genital area showed various points of static mechanical hyperesthesia at the left dermatome of the pudendal nerve. Manual examination of the RIPB also elicited the genital sensations at the left side of the vagina at about the 3 o’clock position.
Conclusions. This patient fulfilled all clinical criteria of ReGS that is believed to be caused by neuropathy of the left pudendal nerve. Clitoridectomy abolished spontaneous orgasms for a great part but not completely, and it did not diminish the typical dysesthesias, paresthesias, and feelings of imminent orgasms that typically belong to ReGS.
(From the abstract for M.D. Waldinger et al., “Restless Genital Syndrome Before and After Clitoridectomy for Spontaneous Orgasms: A Case Report,” Journal of Sexual Medicine 13 Nov 1009, epublication ahead of print)
If this condition is disabling enough for women to take as drastic a step as a clitoridectomy, then it’s no laughing matter. My first reaction was to wonder what doctor would agree to perform the operation, but on reflection I’m willing to bet that this was a last-ditch attempt to provide relief after the woman had tried various drugs and physical therapy to no avail. In other words, it might have been more ethical to attempt a cure through surgery than to refuse it. I still shudder at the idea.
This report also provides some evidence for K’s hypothesis that this syndrome is a result of nerve dysfunction. For what it’s worth, I think she’s right on the money. These are the same nerves that are wired for great pleasure. It’s no surprise that when they go kerflooey, they can cause equally great distress, be it pain, unpleasant tingling, or unwanted arousal.