Health Organization for Pudendal Education

hello, i'm new here. I am a 51 year old woman who has been in menopause for 7 years. A few weeks ago I started experiencing pressure in my butt. the doctor said it was constipation and was given bags to make it easier to defecate. I also went to a pelvic floor physiotherapist and she noticed a lot of tension in my vagina and butt. My tailbone was also swollen. She has corrected this again. I have been free of complaints for 2.5 weeks, but on Sunday evening I noticed a sensation in my vagina and to the right of my clitoris. I was shocked by this and started Googling and came up with PGAD. then came a lot of fear. Very anxious. Didn't sleep. The feeling is still there and sometimes so intense that I don't know where to look. Touch is also sensitive. the only thing that gives me peace at the moment is oxacepam. Could this be due to an overactive pelvic floor? I also see an oncological psychiatrist because I had breast cancer last year. She also made a lot of sense to me. Do I really have PGAD now, can I still get rid of it?

Lovepeps,

It sounds like your symptoms are in the distribution of the PN. Do you have pain in the area you mentioned or is it more of an unwanted arousal feeling? PN can come from tight pelvic floor muscles however an underlying nerve issue can also be the cause of overly tense pelvic muscles.

Stephanies

I only feel pain in my butt. I think it's the pelvis. I started feeling the strange sensation weeks ago in my right buttock and only when moving. Now I also feel it in my clitoris and inside my vagina. The feeling is more intense. I have no pain there. Urinating seems to be a bit more difficult and so does defecation.

-------

Hi Lovepeps,

I can't answer if you can get rid of PGAD but I know people who have, including myself, so I think there is a good chance you can. Yours sounds similar to how my PGAD started. Originally, I didn't have much pain - just that unwanted arousal feeling you are describing, mostly in the vagina. I could not sleep and I had trouble even wanting to eat. I'm 99% cured of that now and for me it was due to pudendal nerve entrapment but it could also be caused by a tense pelvic floor. If it's due to a tense pelvic floor you have to figure out what's causing it to be tense.

I agree with Summer about having an MRI but you may need it to include the lumbosacral area and lumbosacral plexus. And you need to specifically request that they check for tarlov cysts because they don't always mention them on the report. Tarlov cysts are sometimes associated with PGAD.

Your pelvic floor PT can do a vaginal exam and press on the pudendal nerve to see if it is tender. They should also check you for pelvic alignment because if your pelvis is misaligned it can cause pressure on the nerves, sometimes mostly on one side. They should check you for hypermobility to see if your ligaments are giving you proper pelvic support.

Difficulty with urination and defecation can be related to pudendal neuralgia because branches of the pudendal nerve control the bladder sphincter and the anal sphincter.

More diagnostics are important figure out the root cause of what is going on. You could consider having a diagnostic pudendal nerve block to see if it temporarily relieves the symptoms - even partially. Or you could consider a genitofemoral nerve block if your doctor feels that is indicated based on a clinical exam.

I know it's hard while you are going through all of this. I took an SSRI antidepressant that helped significantly with the symptoms until I could get an accurate diagnosis and figure out what treatment to pursue. But it's a strong medication so if you discontinue it, it's wise to wean off of it slowly because some people report developing PGAD from discontinuing SSRI's. I developed PGAD from weightlifting and having bad ligaments that caused a pudendal nerve entrapment but there are different causes. The trick is to figure out the cause for you. I'm wondering how the PT corrected the swelling in your tailbone area and if there is some relationship to what started your arousal symptoms.

Violet

_______

Summer wrote: ↑Sat Oct 21, 2023 1:19 pm

What is the cause of your PGAD Violette ?

Pudendal nerve entrapment at the ischial spine and alcock's canal in the pelvis. I was weightlifting and developed pelvic instability and misalignment that caused the ST and SS ligaments to compress the pudendal nerve. Dr. Bautrant cut the SS ligament to relieve the compression and I am doing great now.

Violet

Hello Violet,

Wich SSRI antidepressant helped you significantly with the symptoms?

My doc gave me pregabaline. I am having doubts to take it.

And how is it possible that when i lay down the arousal is calmer and walking makes it worse?

--------

--------