Little is known about what causes persistent genital arousal disorder. PGAD may be associated with psychological-related pathophysiologies. Women with PGAD have described that stress worsens PGAD symptoms, whereas distraction and relaxation strategies lessens PGAD symptoms. PGAD may be associated with biologic-related pathophysiologies including vascular, neurologic, pharmacologic, and hormonal etiologies. Arterial vascular causes may be secondary to pelvic arterio-venous malformations with unregulated arterial communications to the genitalia. Venous vascular causes may be secondary to pelvic congestion syndrome with ovarian venous incompetence and large varices draining the genitalia. Central neurologic causes may be secondary to Tourette’s Syndrome, epilepsy, post-blunt CNS trauma, post-neurosurgical intervention of central arterio-venous malformation, or to cervical and lumbosacral surgical interventions. Peripheral neurologic causes may be secondary to pudendal nerve entrapment or hypersensitivity. Pharmacologic causes may be secondary to use of certain antidepressants, such as trazodone, or secondary to sudden withdrawal of selective serotonin re-uptake inhibitors (SSRIs) as occurs in sudden SSRI discontinuation syndrome. Hormonal causes may be secondary to initiation and discontinuation of hormone therapy in post-menopausal women, and excess use of herbal estrogens in over-the-counter agents. Some cases of PGAD are idiopathic, or of unknown cause. In two studies it was found that the onset of Restless Genital Syndrome usually occurred in perimenopausal and postmenopausal women with clinical characteristics of small fiber neuropathy of the pudendal nerve including its dorsal branch to the clitoris. depends on underlying cause physician will assist you . about consulting doctor you can ask here only forum or go to the following link : http://bmiatlanta.com/therapists.html