CASE REPORT article
Front. Psychiatry
Sec. Psychopharmacology
This article is part of the Research TopicCase Reports in Psychopharmacology, vol IVView all articles
Development of Persistent Genital Aroual Disorder (PGAD) Due to a Possible Combination of Medications
Provisionally accepted
- 1Univerzita Karlova, Prague, Czechia
- 2Nemocnice Znojmo, Znojmo, Czechia
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Abstract Objective: Persistent Genital Arousal Disorder (PGAD) is a rare and distressing condition characterized by persistent genital arousal in the absence of sexual desire. We present a unique case of a menopausal woman who developed PGAD after combined pharmacotherapy with trazodone, pregabalin, vaginal estriol, and depot medroxyprogesterone acetate (DMPA). Methods: The patient underwent comprehensive gynecological, neurological, and psychiatric evaluation. Menopausal status was confirmed by laboratory findings. A detailed pharmacological review was conducted to assess possible interactions affecting serotonergic, neuronal, and hormonal regulation. Results: PGAD symptoms emerged shortly after initiating the combination of these medications. Each drug has been individually associated with alterations in sexual function, but their concurrent use may have produced synergistic effects on neuroendocrine pathways. Gradual discontinuation of all medications resulted in complete remission of symptoms. Conclusion: This case supports the hypothesis that combined modulation of serotonergic, neuronal, and hormonal systems can trigger PGAD in predisposed menopausal women. Recognition of potential pharmacological interactions is crucial for diagnosis and management of PGAD.
Keywords: Persistent Genital Arousal Disorder, Menopause, Trazodone, pregabalin, Estriol, Medroxyprogesterone, Pharmacological interaction
Received: 20 Sep 2025; Accepted: 30 Oct 2025.
Copyright: © 2025 Fiala and Lenz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ludek Fiala, ludek.fiala@vfn.cz
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