Case Study: 54-Year-Old Man Experiences Constant Sexual Arousal, Feels Always on the Brink of Climax, Must Release or Pain Builds—Two-Year Cycle Explained by Doctor

The Tensia page has shared the case of a 54-year-old foreign patient experiencing persistent sexual arousal over the past two years. The man describes constantly feeling on the brink of climax, compelled to ejaculate continuously—if he doesn't, the buildup causes pain and creates a vicious cycle. While constant sexual arousal might seem desirable to some, this patient finds it torturous, as if something is perpetually lodged in his genitals, leaving his brain no rest.

The symptoms began approximately two years ago when he accidentally visited an adult website during routine internet use. Shortly thereafter, he experienced strange sensations of constantly feeling close to orgasm without any sexual stimulation present. Initially intermittent, the symptoms became persistent, occurring nearly all day and intensifying over time. He began releasing every 2-3 days, but the frequency gradually increased to 2-3 times daily through both masturbation and intercourse with his wife.

Crucially, he derives no pleasure from these releases—they feel forced, done to suppress the symptoms rather than for enjoyment. When he attempts to abstain, the torment worsens: increased agitation, genital tension and pain, and a sense of physical desperation. Relief is only temporary; after ejaculation comes exhaustion, nausea, weakness, and anxiety before the tension returns. His life has become entirely controlled by this condition—ejaculation provides no real relief, while abstinence brings torture.

Eventually, he consulted a urologist who conducted extensive testing: CT scans, ultrasound, cystoscopy, and brain MRI—all came back completely normal. No tumors, no neurological disease, no prostate abnormalities, no vascular issues. His only history was a previous urinary tract infection, long since treated.

He then visited a sexual health clinic where the doctor noted his severe anxiety and guilt about the day he accessed adult content, as if his mind was linking it to the condition's onset. However, no psychiatric disorder, psychosis, or severe depression was found.

After thorough evaluation, the doctor diagnosed him with Persistent Genital Arousal Disorder (PGAD), also called Persistent Sexual Arousal Syndrome (PSAS). This condition involves the body becoming sexually aroused continuously without genuine sexual desire. Symptoms include persistent genital tension, constant near-orgasm sensations, pain and burning, the urge to ejaculate for relief, but without actual satisfaction—leaving many patients unable to function normally.

Critically, PGAD differs from typical high sexual arousal because patients don't actually "want" it; their bodies remain perpetually switched on, as if the genital nervous system is abnormally stimulated at all times. While the exact cause remains unknown, multiple theories exist regarding abnormal nerve sensations and neural dysfunction.