There are women who do not even know what an orgasm feels like. Others must exhaust a man, squeezing it like a lemon to achieve one. And here is the British Sarah Carmen, 24, which can have up to 200 daily without even having sex. That's because she slightest vibrations are enough for her, even the rumble of the train, the purr of a hairdryer, or the rhythmic drone of a photo-copier.

"Anything can set me off. Even the hairdryers cause funny pulsations through my body. As a skin care specialist I have to use tools which vibrate a lot of the time for micro-dermabrasion and they sometimes set me off."

"My friends think it's great. I have more orgasms in one day than most of them will probably have in a year. They say to me that they feel lucky if their boyfriend makes them have one orgasm-some days I have one every ten minutes." said Sara.

The London young woman developed Permanent Sexual Arousal Syndrome (PSAS) by the age of 19, after being prescribed anti-depressants. "Within a few weeks I just began to get more and more aroused more and more of the time and I just kept having endless orgasms. It started off in bed where sex sessions would last for hours and my boyfriend would be stunned at how many times I would orgasm. Then it would happen after sex. I'd be thinking about what we'd done in bed and I'd start feeling a bit flushed, then I'd become aroused and climax. In six months I was having 150 orgasms a day-and it has been as many as 200.", said Sarah.

Since then, Sarah had several relationships. "Often, I'll want to wear myself out by having as many orgasms as I can so they stop and I can get some peace. Sometimes I have so much sex to try to calm myself down I get bored of it. And men I sleep with don't seem to make as much effort because I climax so easily.", she said.

While being interviewed by Newsoftheworld (http://www.newsoftheworld.co.uk/0311_200_orgasms_extra.shtml), Sarah said she had had 5 orgasms in 40 minutes. She said she has troubles even at her workplace, as whirring hairdryers and skincare gadgets turn her on easily. "If I start coughing and run to the loo, the girls know to fetch the client a magazine or a cup of tea. Sometimes I'd like to just have a normal life." explained Sarah. "I was doing a bikini wax and you have to really concentrate and keep your hands very still, and mine go a bit wobbly when I orgasm. I had to pretend I had cramp in my foot and just stood there wriggling around on the spot and stifling my moans until it was over."

Noisy bars are out of the question for Sarah. "We have to find nice quiet bars. I have more orgasms if I have a drink as it relaxes me so I tend to drink very little now."

But PSAS is not sex addiction or nymphomania. These patients do not have increased libido. Sarah participated at a meeting of Sex Addicts' Anonymous.

"But when I looked around the room and heard the stories other people told, about how desperate they were for sex, I realized I wasn't like them. With me, it was a means of releasing my orgasm, but now I know I don't have to have sex to do that."

PSAS is such a rare condition, that experts admitted its existence very recently. It represents a spontaneous and persistent genital arousal (accompanied also by breast congestion), with or without orgasm or genital engorgement/swelling/lubrication, but not connected to a higher sex drive (patients are annoyed by this arousal) and which generally is unwanted and intrusive. PSAS patients frequently report shame or embarrassment.

The physical arousal can be very intense and persistent, for days, weeks or permanent. Orgasms can sometimes trigger temporary relief, but no mater the amount of sex intercourse/masturbation a person might have, after several hours the symptoms come back.

In some cases, 300 spontaneous orgasms/day were reported. Not only a man cannot cope with such sexual demands, but he can feel overwhelmed by such a PSAS woman. The syndrome can work on "spot" areas, like deep in the vagina, or in the clitoris area.

The subject's activity and focusing are impaired. Even riding in an automobile or train, mobile phone vibrations, and a bath use spur into unbearable symptoms with strong sexual urges. "Sitting is unbearable, sometimes causing pressure to orgasm. Standing is the only time I feel nothing. Sitting in a car is torture. The opening of the vagina is just as sensitive and a mere touch will bring me to orgasm. My husband is very sympathetic and relieves the terrible pressure anytime I ask. Those close to me that I've told about this at first think it's funny and then realize that indeed it is not."

"I was constantly feeling overwhelming sensations of sexual arousal, which were purely physical and not accompanied by romantic or sexual fantasies. Basically I felt the need to have repeated orgasms which was never relieved by normal orgasmic experience." These were other two PSAS patients.

The partner can feel impotence and confusion, incapacity in providing relief, isolation, frustration and anger. The patient, besides shame, isolation, and impotence, can experience vulnerability and sadness, being awakened in the morning by hot flashes. At the workplace, an employer will see negatively an employee going every five five minutes to the bathroom.

The condition is still a puzzle for the researchers: it could be some pelvic inflammation or infection stimulating clitoral and other sensory nerves, and tends to occur mostly in post-menopausal women in their 40s and 50s, or those who were subscribed a hormonal treatment; but the age can vary a lot.

Others say it is psychological symptom of some emotional crisis connected to the brain's limbic system, the center of pleasure and sex physiology. A brain tumor in a nucleus connected to genital area has been recorded in a case, and also ovary tumors.

Drugs like trazodone induce PSAS as a side effect, but also stopping SSRIs (serotonin reuptake inhibitors, a class of antidepressants), like in Sarah's case, or cholesterol-lowering treatments can have the same effect. One patient experienced PSAS following surgery for urethral prolapse. A pelvic arterial-venous malformation with arterial branches to the clitoris can induce PSAS, and surgery can cure completely in this case.

Medication against PSAS are antidepressants, antiandrogenic agents and anaesthetising gels; medical treatment of irritating neurologic lesions; psychotherapy also helps.