Health Organization for Pudendal Education

Hi everyone,
I'm sorry if this is long but I really need some input on where to start. I'm am 21 weeks pregnant with my 3rd child. The first 16 weeks I was in and out of hospital with severe morning sickness. I was given drugs to stop the vomiting including zofran and metroclopromide which I had a terrible nervous system reaction to. Shortly after this event I started to feel that my bladder was sore and my lower back tight and my lower abdomen always clenched. Then I noticed every day for a while feeling very aroused. I ignored it and it would go away eventually. As I started to recover from the morning sickness and became more active I noticed the arousal more until one morning I woke up with it and it didn't go away. I thought that I had injured myself by being still weak physically and doing to much in the garden as my legs had been shaking with the muscle strain.
The symptoms now are attacks of muscle spasms in my lower back, lower tummy, vagina, pelvic floor that leave me in terrible orgasmic rigour for 2 days. Having orgasims only make it worse! Then once the rigorous stop I'm left with the arousal 24/7 at an unbearable intensity for another 6 days or so. I then will have 1 day of no arousal just pain and tenderness around my pudendal nudge on the left side and tingling on my labia. Then the next day it will start full force again leaving me crying and out of my mind again.
I have 2 little girls and a little boy in my belly that I can't care for. I'm just so so sad and distraught. I don't know if this is caused by nervous system dysfunction or physical injury from being so weak and sick. I live in NZ so the resources here are minimal to treat this.
Where do I start? What do I suggest to my specialist? I can't take most meds during pregnancy. The only thing I have started in internal physio to help release my pelvic floor.
I feel like this is hopeless and my life over. How am I going to care for my newborn?
Any advice would be so much appreciated.
Rowie.

Hi Rowie,

I'm very sorry you are having PGAD and I agree with you that it is dreadful. If you have a tight pelvic floor hopefully the PT will soon provide some relief.

It might be good to have an MRI if you are past the first trimester just to make sure there is nothing obvious that could be pressing on the sacral nerves.

For symptom relief you might try some ice (frozen balloons inserted vaginally) and external ice for some symptoms relief since you can't take medications. Maybe check with your doctor if this is OK first. Definitely quit the outdoor garden activity that causes muscle spasms if you haven't already.

There are some antidepressants that are considered safe or low risk during pregnancy. http://www.mayoclinic.org/healthy-livin ... t-20046420 Zoloft is on the list and it is one of the drugs that helped dampen my symptoms of PGAD considerably. Tricyclics may also help. There may be a bit of trial and error involved in figuring out if these help you. You could also check with your doctor or pharmacist whether any topical ointments such as extra-strength vagisil cream are OK to use now.

I hope all goes well for you with the pregnancy and hopefully over time the symptoms will calm down as you heal.

Violet

Did a bit more checking and opioids are also considered safe during pregnancy. For some people they help dampen the symptoms of PGAD.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2809170/

I know one woman who uses buprenorphine successfully to get rid of symptoms of PGAD. Here is a study on its effects during pregnancy.

http://www.medscape.com/viewarticle/739191

Violet

Thanks so much for your input. I'm just consumed with worry about everything and adding in more health risks to the baby is just sending me over the edge. My family is struggling, we have to pay for a nanny for my girls. I feel like my life is slipping away. It's only been 10 weeks of pgad but it is severe, I can hardly sleep or eat or leave the room and I'm trying to grow a baby! The urge to relieve the pressure means my muscles uncontrollably spasm. This is pure hell. I feel in crisis but I simply don't know what to do.
I do have an appointment in 2 days with a new doctor so will ask about the meds. Does anyone else get buzzing down the spine into the lower back? It feels like my nervous system is super charged. The only time I don't feel extreme arousal is when doing a BM or peeing. I don't know what this means though.
Thanks so much for any input.
Rowie

Rowie, I had it 24/7 too and I know what you mean about pure hell. I could hardly sleep or eat until I found some remedies that helped -- especially ice. I don't remember exactly but sometimes I've had burning through my torso and back, sometimes I've had shocks causing muscle spasms down through the abdomen into the pelvis and sometimes it felt like they were more through the spine. I had central nervous system wind-up so bad that I would jump when the phone rang. Clonazepam was a lifesaver for getting a few hours of sleep. Until I started taking that I was severely sleep-deprived but unfortunately it is considered a class D drug and not safe for pregnancy. Soma is a class C drug so is somewhat safer. Benadryl and ambien are class B drugs so somewhat safer yet. Ice balloons inserted vaginally might be one of your best bets for vaginal muscle spasms. Helped me get to sleep on many nights. You could also try a gel ice pack on your lower back.

Violet