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PGAD in Males

What is Male PGAD?

Persistent Genital Arousal Disorder in males, also known as Male PGAD or Restless Genital Syndrome or Persistent Genital Arousal Syndrome, is a condition characterized by unrelenting, spontaneous and uncontainable genital arousal. This disorder has been mostly studied in females; however, it is not limited to women. Cases of persistent genital arousal disorder in males are now being reported more often.

speaking to a patient about male pgadFor men, this disorder is often confused with priapism. Priapism is a condition in which a penis remains erect for hours in the absence of stimulation or after stimulation has ended. The causes of priapism can be ischemic (which is when there is low blood flow), non-ischemic (which there is high flow) or recurrent ischemic (when it is off and on.) In persistent genital arousal, there is no ischemic cause of the genital arousal.

Patients are typically worked up by urologists for penile ischemia, as well as prostatitis (bacterial or abacterial), urinary tract infections, and Peyronies.

Understanding Hard Flaccid Syndrome and PGAD in Men

The condition Hard Flaccid Syndrome and its symptoms overlaps with persistent genital arousal and is quite possibly the reason the diagnosis of Persistent Genital Arousal Disorder in Males has been missed in so many patients. Hard Flaccid Syndrome is considered a condition where the penis is hard to touch, however not erect. During a typical state of flaccid, the penis is soft or spongy. In this condition, the penis is hard (about 30-40% as compared to an erection.) Males are less likely to report symptoms of erectile disorders, pelvic pain, and sexual dysfunction as compared to females.  Some existing risk factors may be; anxiety andstress, gender (male), prolonged sitting, biking, hernia, prior pelvic surgery, and pelvic floor muscle spasms.

Treating Persistent Genital Arousal Disorder in Men

At Pelvic Rehabilitation Medicine our practice is composed of both males and female as we believe all pelvic floors are created equal. By treating the chronic muscle tension in patients with hard flaccid, we are able to improve blood flow to the pelvis by creating space and allowing for oxygenation. We also decrease the muscle tension with trigger point injections to the pelvic floor muscles that are done externally with ultrasound guidance. Our treatment also shuts down the chronic pain cycle that causes these symptoms to persist.

If you think you may have Male PGAD or Hard Flaccid Syndrome, we can create a treatment plan after a thorough history and physical examination are done.


Patient safety is our utmost priority at Pelvic Rehabilitation Medicine.

Meet Pelvic Rehabilitation Medicine

At Pelvic Rehabilitation Medicine, we treat whole human beings, not symptoms. In the body, everything is connected; and the pelvic region is the vital center of the body’s connected functioning. Our physicians take an innovative approach, combining traditional medicine with holistic modalities and rehabilitative medicine. We treat both male and female patients who experience core muscle and nerve problems; chronic pelvic pain; and pelvic floor muscle dysfunction. Learn More »

Relevant Publications/Citations

Allyson Augusta Shrikhande, MD. Interviewee on Pelvic Health Summit - CPPS. Pelvic Health Summit. 2018 May. Link to Interview.

Allyson Shrikhande, MD sits as the chair of the Medical Education Committee for the International Pelvic Pain Society. Link to Medical Committee.

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Practice Safety Protocol

The health and safety of our patients and employees is Pelvic Rehabilitation Medicine’s top priority. While remaining open, our Team is strictly adhering to the recommendations offered by the CDC, and our disinfecting policies are meticulously executed in each of our offices. We assure you a healthy, safe environment while bringing you the exceptional healthcare you deserve. 

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