PGAD - persistent genital arousal disorder

[Violet M]

Yes, you should be able to tell if you are straining -- it would be a conscious decision. I think damage to the pudendal nerve from straining would take place over time -- it wouldn't be an isolated incident.

Violet

[clo236]

Hi Violet,

I've woken up with the pgad again this morning. This symptom makes me feel physically ill, like how are you meant to cope with it? How can I go back to uni and study it makes me so creeped out. I should never have changed pregabalin in the first place. I'm on 150mg today so this is the fifth day and it take a few weeks. I just don't know how I'd cope if it was here to stay. I have pins and needles in that area also that never really went
Can noritryptline help with the pgad aswell, as the pain management doc prescribed that in combination but it has to be a low dose because I am on lexapro already so about 20mg.
I feel so clumsy/ accident prone. I might have hit my bum of the arm chair when getting up from picking something up. That wouldn't cause damage would it? Just maybe a flare?

Thanks,

Chlo xxx

[clo236]

This sounds like a really odd thing to say but it feels like there is something stuck up my bum. I am prone to IBS when I am anxious though so maybe that's a cause. Its just its making me very aware of the muscles down there.

Like I was doing some deep breathing exercises and I could feel a downwards movement of my muscles, I don't know what I'm doing I'm still worried about the whole straining business. Is it only in reference to going to the toilet??? Then later I was picking something off my arm (sounds a bit weird) but I was pressing on it and I could just feel this pressure around my anus area. I hope I'm not somehow pushing.

Reading some of these posts on pgad makes me feel so sad for everyone suffering this.

Chlo xxx

[Violet M]

Chlo, yes, nortriptyline might help. I understand the creeped out feeling but I think with the right treatments you can get better.

I can't see how deep breathing exercises would hurt anything. The type of straining you should avoid is the straining you would do to push out a BM. If you are pushing hard it can damage the nerve over time. If you are prone to constipation you might want to ask your physician about what to take for it. I use magnesium citrate tablets on a regular basis.

Violet

[clo236]

Hi Violet, thought I'd update about PT. went to see a women's health physio who said that my right hip wasn't really in line and was a bit stiff so she worked on that and then. She checked my pelvic floor and said it wasn't releasing that well. Then yesterday she was trying to massage out the trigger point they were so sore on the inside on the right hand side. All my pain seems to be in the right hand side. I still don't know what's going on with my toilet habits. I had a good flow pee this morning then the muscle went right into spasm and I tried to relax it by contract and relaxing but I think I might have pushed the muscle for 1 second. It just makes me panic that's I've caused more damage or the pgad will get worse. I mean I'm not bearing down and pushing. I think I'm having a bit of a flare from PT aswell xxx

[Violet M]

Chlo, most of my pain was on the right side too and I used to have flare-ups after PT. It sounds like you might have some musculoskeletal issues that hopefully your PT will be able to help you with.

Some other gals on the forum have had hip problems including femoral acetabular impingements or labral tears. Maybe it would be a good idea to have your hip checked out -- or at least mention it to your PT and see what she thinks.

Violet

[nonsequitur]

clo, I remember reading your first post. You had a fairly insignificant incident but were experiencing major stress at the time.
You also posted that you have IBS that gets worse when you are stressed and suffer from anxiety.

In my opinion, the more you obsess about your pain and the myriad of possible physical explanations, the worse it will become.
You are young and you did not have major surgeries. On the other hand you suffer from anxiety, IBS, and you were majorly stressed at the onset of your pain.
Those are major signs of possible somatization.

Try to fill-up the standard somatoform disorder form (PHQ-15) to see if you qualify:
http://iapt.nhs.uk/silo/files/phq15-pdf.pdf

Feel free to ignore, but I suggest you read John Sarno MD for another perspective on what you may be experiencing.
I can relate to your medical journey, your ever increasing anxiety over this, but I eventually recovered.

http://bmcpsychiatry.biomedcentral.com/ ... 244X-13-91
Somatization is one of the most common issues in health care services, associated with substantial functional impairment and health care utilization. Their valid and reliable acquisition is urgently necessary. Somatoform symptoms often account for sick leave and are characterized by long duration and medically unexplained symptoms. The most frequently reported symptoms are fatigue, low energy, sleeping trouble, and pain.

[clo236]

Hi Violet,

Yea the physio was gave me exercise to relax my pelvic floor and she was even saying that after a week the muscles seem to be able to relax better. I didn't even realise I had pain up in side my vagina until she started poking about.

I'm on day 9 of pregabalin up to 250mg, I do feel better than I did before but that horrible sensitivity at my clitoris is still there. it just worried me that you aren't guarenteed for a drug to work even if did previously work before.

I was lying on my side yesterday with a cushion between my legs and somehow my cat managed to kick my bum perineal area when she was jumping off the sofa. Sounds so silly hopefully that wouldn't do anything permanent.

I'm still very conscious of my muscles though every time I put pressure on any part of my body like picking something, scratching or whatever I worry that I'm pushing down on my pelvic muscles but I know I'm not bearing down or anything.

I don't want this PN do ruin my life I already have resits of exams I couldn't do in the summer which means I won't be able to apply this summer for an internship.

I'm just frustrated and scared basically.

Thanks,
Chlo xxxx

[Violet M]

Hi Chlo,

Well, I'm sorry this has affected your life significantly but it sounds like you are doing better and I think with time you will continue to do better and be able to put this behind you. If PT helps that is a good sign. Since you won't be able to do an internship this summer, maybe you can find something else to do over the summer to keep your mind distracted. I think it's good to stay busy with something if you can.

Violet

[Susanjane]

Clo236
Reading your posts, I too have made the same observations as Nonsequitur and seen that much of your suffering is driven by fear, especially fear of causing even more damage by fairly minor incidents or mishaps. The mechanism of pain is complex, but this link http://www.bboyscience.com/damage-does-not-cause-pain/ explains things simply and might help you keep a sense of perspective. Is it not possible for you to get some effective medication to help with the anxiety, at least for the time being, in order to bring you some peace? This in itself may provide some pain relief.

Regarding somatoform pain disorder, the pain is never in dispute, just the origin of it. You may like to read my longer post under Success Stories.

You are only young and have had this for a long time so I hope you are soon able to find a way to heal and enjoy the life you have ahead. Good luck!