Female postmenopausal patient having orgasms during sleep

At present, there is an increasing level of interest about abnormal sexual behavior occurring during sleep, which is called sleeping sexuality or atypical sexual behavior during sleep and sexomania. ICDS-2 treats this phenomenon as a variant of confusional excitation, which is included in parasomnia classification. This disorder may present itself as creating sexual sounds during sleep, speaking or yelling, masturbation, caressing someone else, sexual intercourse during sleep, aggressive sexual behavior, ictal orgasm, ictal automatic sexual behavior, ictal pelvic motion that looks like a sexual intercourse. The case is a 69 years old female patient, who is an elementary school graduate, married and housewife. She appealed to our clinic on October 2013 with complaint of having orgasm in her sleep at least once a week, at most once in two weeks interval. In late periods, her orgasms got intense enough to cause sub-sclerotic hemorrhages in her eyeballs. She had no dreams of sexual content prior to orgasms. MRI scan was clear and EEG showed no signs of any epileptic pathology. She was treated with 1 mg/day clonazepam. She returned for control visit 3 months after medical treatment. She reported no orgasm during her sleep after clonazepam treatment. There are 3 such cases in the literature as far as we know. Our patient is the oldest patient in respect to those reported in the literature. As this is a rare pathology, we thought this case would draw attention to this problem and would supplement the literature.