A woman with restless genital syndrome: a difficult-to-treat condition

BACKGROUND: Restless Genital Syndrome (RGS) refers to the uncommon experience of excessive and persistent sensations of genital and clitoral arousal, with either restless legs or symptoms of an overactive bladder, in the absence of conscious feelings of sexual desire. RGS is caused by a small fiber sensory neuropathy of the dorsal nerve of the clitoris. To date, there is no consensus on the treatment for RGS. CASE DESCRIPTION: A 58-year-old woman presented with persistent and unwanted genital arousal in her clitoris and labia minora. The arousal symptoms were accompanied by restless legs. Despite the pre-orgasmic feelings, orgasm was not achieved. Sexual activity did not resolve the symptoms. Two months prior to the onset of RGS symptoms a presacral abscess had been drained. CONCLUSION: Lidocaine, oxazepam, clonazepam, tramadol and transcutaneous electrical nerve stimulation, combined with psychotherapeutic counseling, have been described as the most appropriate treatment modalities for RGS based on the experiences to date.