Restless Genital Syndrome (RGS) is a rare somatosensory disorder, increasingly being recognized as a variant of Restless Legs Syndrome (RLS), that is characterized by unpleasant sensations involving the genital area and pelvis. RGS has been defined as a “spontaneous, intrusive, and unwanted genital arousal that occurs in the absence of sexual interest and desire.”3 This condition has been called by other names, such as vulvar dysesthesia or persistent genital arousal disorder.
With RGS, patients complain of a discomfort in their genital area, often described as a burning sensation, tingling, pain, itching, or throbbing. “Often [patients] say that it is difficult to find a word to describe their symptoms,” Dr. Aquino told Medscape. Symptoms tend to be worse when patients are sitting or lying down, particularly in the evening, and may be alleviated by standing and walking — very similar to typical RLS symptoms.
The cause of RGS, like RLS, is not fully understood. However several mechanisms have been proposed: reduced iron levels in the central nervous system, and abnormalities in circadian rhythm and in various neurotransmitters, such as dopamine, glutamate, and opioids. Genetics may play a role as well.
An association with Parkinson’s disease (PD) has been suggested. In a case report published in JAMA Neurology,4 a woman with PD and disabling genital discomfort was discussed. The woman described a sensation of “congestion,” itching, and “growing” of pelvic organs, symptoms that were triggered by sitting or lying down. She did not experience restlessness in her legs, but her symptoms responded well to the dopamine agonist pramipexole.
The authors concluded that RGS should be considered a phenotype of RLS, as should restless bladder and restless abdomen. They emphasized that a detailed clinical history is essential for this diagnosis and that treatment with dopamine agonists can provide some benefit.5
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Have You Heard of Restless Genital Syndrome?