Hi Balenul,
First of all, I would like to say again that everything I write is my personal opinion, because it does not always agree with medical opinions.
Before I go into PGAD in more detail, I would like to write something that I found on my journey through literature - especially trauma literature.
At some point I ended up with Wilhelm Reich. He was a student of Sigmund Freud and lived from 1897 - 1957. Like all psychoanalyts he dealt with sexuality, was the first to deal with body therapy and the first to have the idea that the autonomous nervous system plays a major role.
In one of his books from 1927, Reich describes cases of female patients. Some of them showed typical PGAD symptoms, which are now part of the diagnostic criteria. Reich also describes the life stories of the patients. They were all horribly traumatized with multiple traumas. Reich diagnosed them with nymphomania.......there was no other idea in these times.
Why am I writing this?
I consider PGAD to be a trauma-related syndrome. Traumas can be manifold. It's not always the big event that throws us off our way. Everything we experience is stored in our nervous system, which can then lead to a wide variety of reactions at some point.
I think PGAD is a very old syndrome, primarily in women, but also in men. Since the use of psychotropic drugs, which can lead to sexual dysfunction, this syndrome has become more and more public. Furthermore today people speak more openly about sexuality than 100 years ago. And.....it was a woman, a US psychologist, Sandra Leiblum, who first described the syndrome and who said that the women are not nymphomanic.
But now to today's PGAD
The central and the autonomic nervous systems are influenced by both, trauma and psychotropic drugs. The central nervous system sends neurotransmitters to the brain, to say it in a very simply way. That's why medicine believes that they are able to influence the neurotransmitter Serotonin and it could resolve depression. It seems this oppinion didn't go well. Firstly, PGAD cases and other sexual dysfunctions seem to be increasing, secondly, the serotonin hypothesis has been scientifically refuted, it is nonsense. I estimate that on the German PGAD forum 80% of all PGAD cases took psychotropic drugs or suffered from PGAD after stopping them. Many patients report depression/anxiety disorders. As far as I know, in the meantime it is reported in the instructions that sexuality can be affected.This kind of side effect is absolutly not taken seriously by medicine. If they did, they took these pills from the market.... at once. Because no one who doesn't experience these feelings can imagine what it means.
If you want to learn more about psychotrpic drugs and “mental disorders” have a look at “madinamerica.com”, a very serious and enlightening website. Or do read the books from Prof. Peter Gotzsche.
Now I come to the autonomous nervous system. In the meantime in trauma research the “fight or flight – freeze” conditon is well known.
If a person is exposed to constant stress, this condition can arise in the autonomous nervous system. But it can also be caused by accidents, medical operations and other direct negative physical experiences.
The “fight or flight” state means for the body: concentration, tensing the body, accelerating breathing, clenching the teeth, adjusting digestion.
When this state runs automatically, the body is overwhelmed and goes into "freeze". This can be depression, CFS (Chronic Fatigue Syndrome), polyneuropathy due to the tensions and much more.
Of course, the tensions happen completely unconsciously, as we are not constantly faced with great danger and have to fight or flight.
For me, PGAD is a "fight or flight" state that is conditioned and not so easy to stop. Something has happened in the brain, in the Amygdala??, that runs in continuous mode. This would also explain why SSRIs, which are supposed to stimulate the person and eliminate depression, seem to do "too much" and cause overexcitation or, in the case of PSSD (Post SSRI Sexual Dysfunction), total numbness of the genitals and the feelings.
Yes, the pelvic floor plays a big role. But human beings have three diaphragms: pelvic floor, diaphragm and throat, and all three are constantly interacting with each other.
If I am constantly in “fight or flight”, I (unconsciously) tense the pelvic floor, hold my breathing or only breathe in the upper part of my body and clench my teeth. All three diaphragms are therefore under maximum tension. That's why I wrote that
conscious, correct breathing is so important. This needs to be practiced, if possible with a therapist.
By the way, Prof. Krüger works with psychotropic drugs, as far as I know. I have never spoken to him personally. On this forum a German woman wrote she could manage the feelings with several psychotropic drugs. One of it is Duloxetin
viewtopic.php?t=9774. Another woman I know personally had no success, in the opposite, the feelings grow up by this medication. It seems, medication and PGAD is a gambling.
Of course you can try a Botox injection into the pelvis. Nevertheless perhaps you also look for a pelvis therapist to learn to relax it more and more. Today those therapists know very well that the jaw has to be treated too.
I wish you all best and hope that the injection gives you a bit relief.
Aristocat