Understand Pudendal Neuralgia

November 12, 2012

Understand Pudendal Neuralgia

Many “random” pains are treated with medication in hopes that it will eventually heal. Unfortunately, people with pudendal neuralgia can suffer for months before an accurate diagnosis is made.

Nerves are responsible for transmitting information between different parts of the body and the brain. When the nerve receptors become aggravated or damaged, it can result in pain and restricted movement. Pudendal neuralgia results when the pudendal nerve becomes inflamed. It has a tendency to be very painful which often causes people to seek out medical attention. Because pelvic pain can be caused by a variety of ailments, diagnosis can be rather delayed.


Anything that could cause damage or pressure to the nerve area in the pelvic region can result in pudendal neuralgia. This leads to a fairly long list of possible causes but some of the common sources of sensitivity are:

  • Falling directly onto the tailbone

  • Giving birth can inadvertently cause trauma in the pelvis

  • Excessive straining when defecating

  • Chronic constipation

  • Exercises involving a lot of squatting

  • Cycling

  • Reoccurring vaginal infections

  • Complication of surgery

  • Pelvic floor dysfunction or any other type of abnormalities in the area

Signs and Symptoms

Any condition which causes nerve problems can result in a wide range of symptoms varying in severity from simply being uncomfortable to being in a great deal of pain. Individuals with pudendal neuralgia can experience any of the following primary symptoms:

  • Odd internal sensations- Some people report a strange sensation of an object being inside of them. Generally, it can feel as if something foreign is resting inside the rectum or vaginal area.

  • Problems with sexual health- Pelvic pain can make intercourse very uncomfortable. There may also be an overall decrease in all sensations from the genital area. This can make it difficult for women dealing with pudendal neuralgia to reach climax. Men can experience pain while getting an erection which can make it difficult to maintain one. Painful ejaculations may occur. Treating the nerve problem should result in restoration of sexual function.

  • Pain- Many people report pain which occurs while sitting down. It may not be too bad in the morning, but the intensity will often increase as the day goes on. Lying down, walking, or standing can lead to relief of pain symptoms. The pain may be across the entire pelvic region or simply on one side and can be present in the rectal, penile, or clitoral areas.

  • Difficulty when using the restroom- Constipation is a common side effect of this condition especially because patients have painful bowel movements from straining. Problems with urination like increased frequency and hesitation have also been reported. Pain can appear for a while after voiding. Incontinence is present under severe circumstances.

Diagnosing and Treating Pudendal Neuralgia

Pudendal neuralgia is normally diagnosed after other possible conditions have been ruled out. The symptoms are often seen in a number of other conditions and diseases such as prostatodynia, pelvic congestion, interstitial cystitis, and anorectal neuralgia. Once other possibilities have been ruled out, your doctor will run tests in order to determine whether you are suffering from nerve entrapment or from a tension/compression problem. Treatment options will vary depending on whether you are experiencing a true nerve entrapment situation or if you have skeletal/muscular abnormalities. Treatment includes surgical decompression, physical therapy, and pudendal nerve blocks.


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