Health Organization for Pudendal Education

Wow, check out these links:
http://www.restlessgenitalsyndrome.com/en/articles.html
http://www.psas.nl/
http://www.psas.nl/waldinger/default_en.htm

short version... see sites for MUCH MORE links, info, help!
In 2009, Prof. Dr. Waldinger and his colleagues have published five important articles on Restless Genital Syndrome.
Prof. Waldinger has been the first to identify the real cause of ReGS and therefore also the real cause of PSAS or PGAD. It is a small fiber sensory neuropathy (SFSN) of the dorsal nerve of the clitoris (DNC), a small nerve in the vicinity of the clitoris and vagina.
Prof. Waldinger has also been the first to show the efficacy of TENS treatment for ReGS, PSAS or PGAD.

IMPORTANT!! Some internet sites, particularly in the USA, state that PGAD is a newly described disorder that is not yet fully understood or defined and is difficult to treat. This is unfortunate as it gives the impression that PGAD still is a rather mysterious disorder. But it is not. These websites are not up-dated with recent research. The studies of Prof. Waldinger have shown that ReGS, including PSAS or PGAD, is a well-described neurological disorder that can be treated with TENS and or medication (daily clonazepam, or oxazepam, or on-demand tramadol; local injection with bupivacaine 0.5% or bupivacaine 0.5% + 40 mg methylprednisolon)

Cause of Restless Genital Syndrome

Scientific research conducted by Prof. Waldinger and his colleagues has shown that Restless Genital Syndrome is caused by a disorder (a sensoric neuropathy) of a short small nerve, the dorsal nerve of the clitoris. This nerve is a distal branch of a longer nerve, the pudendal nerve, and is located left and right next to the vagina and clitoris. Research of Prof. Waldinger has also shown that ReGS may occur in concurrence with:

1. Varices in the pelvis (pelvic varicose veins)

2. Hormonal changes (estrogens); for example,
- a few days before the onset of menstruation,
- in the last part of pregnancy,
- around and during menopause,
- during treatment with anti-estrogens (these medications are prescribed in case of breast cancer)

3. during the use of, during dose reduction, or after stopping the use of modern antidepressants

Thank you for posting this PG. I found cause #3 especially interesting. I weaned myself off of Lexapro in the spring of 09 and then had a VERY stressful summer and in the fall the pain started.

PG, thanks for posting this. I'm glad he's doing research on this but he's incorrect in saying that this problem occurs only in women. We've had men post on the PN forum who had the same problem. I believe PSAS/PGAD can have different etiologies, one of them being nerve damage, including pudendal neuropathy. I have to believe that was the cause in my case because I had never taken antidepressants before and I am essentially cured of this problem after release of the PN surgically.

I've also known women whose problem started after discontinuing SSRI antidepressants and I'm not sure what the disease mechanism is in their case. I suspect it has something to do with a disruption of the neurotransmitters since SSRI's impact the re-uptake of seratonin but I have not yet read any research that confirms the exact cause.