When it comes to urological disorders you would be forgiven if you thought there is nothing new under the sun – but you would be wrong! A condition known as Restless Genital Syndrome (RGS) wasn't known before 2001, and even then it was christened “persistent sexual arousal syndrome.” As the disorder became better understood, it got a name change to "persistent genital arousal disorder" in 2003, and finally to RGS in 2009 when an association with restless leg syndrome was discovered.

The symptoms of RGS include a discomfort in the genital area which is described as a burning sensation, tingling, pain, itching, or throbbing. The symptoms tend to get worse when patients are sitting or lying down, especially in the evening. In some cases the discomfort can be alleviated by standing and walking, and sufferers report an urge to get up and move.

Doctors derive insight into the causes of RGS from what they know of restless leg syndrome. These include reduced iron levels in the central nervous system; and abnormalities in circadian rhythm and in various neurotransmitters, such as dopamine, glutamate, and opioids. Genetics is another likely factor, as it plays an important role in 40 to 60 percent of restless leg syndrome cases. 

And because renal failure, iron deficiency, neuropathy, myelopathy, pregnancy, multiple sclerosis, and Parkinson disease all have been associated with Restless Leg Syndrome, doctors surmise there may be an association with RGS as well.

As you might now expect, the treatment for RGS takes its page from the Restless Leg Syndrome playbook as well. Dopamine agonists – such as pramipexole, ropinirole, rotigotine –  are considered be very effective, along with pregabalin, gabapentin, and levodopa (although levodopa more often results in a complication known as augmentation, with symptoms occurring earlier in the day and spreading to other body parts). Opioids and clonazepam are also used, and iron supplementation is recommended in selected patients, mainly in those with low iron levels.