Pudendal neuralgia
Overview
Pudendal neuralgia is nerve pain in the genitals, bottom, anus or pelvis. It can last a long time, but there are treatments that can help.
Symptoms
The main symptom of pudendal neuralgia is sharp, shooting, burning or tingling pain (nerve pain) or numbness in your: genitals (your vagina, vulva and clitoris or penis and scrotum)bottom and anusperineum (the area between your genitals and anus)pelvis The pain may be worse when sitting down and may get worse throughout the day. Other symptoms can include: needing to pee more oftenpain when peeing or pooingconstipationa feeling of swelling or fullness in your anus or vaginadifficulty getting an erectiondifficulty reaching orgasmpain when having sex
Causes
Pudendal neuralgia is caused by damage to the pudendal nerve, which is one of the main nerves in your pelvis. Possible causes include: an injurydamage from surgerygiving birthactivities that put pressure on the nerve such as cycling, horse riding or sitting for a long timea growth or tumour that puts pressure on the nerveinfections such as genital herpes Sometimes it's not clear what causes it.
Treatment
Pudendal neuralgia can be hard to treat. The treatment will depend on how severe your pain is and what's causing it. A GP may recommend treatments such as: physiotherapy, including advice on exercisesmedicines that can help with nerve pain, such asamitriptyline,duloxetine,gabapentinorpregabalina strong painkiller calledtramadol, if other pain relief does not work and you need pain relief for a short time while you're waiting to see a specialist If you have severe pain or it's affecting your daily activities, the GP may refer you to a specialist in nerve conditions (neurologist) or a specialist pain clinic. Treatment from a specialist may include: injections to reduce painsurgery, if something is putting pressure on a nerve and other treatments have not workedpsychological therapies such ascognitive behavioural therapyto help you cope with pain