Similar to PN, from rough sex

[DM2323]

Hi everyone, I am a 33 year old male suffering from similar symptoms of PN for the past 2 years but from an acute local rough sex experience. Long story short, was way to rough on my penis during sex, and ever since the skin before the head on my penis (i'm circumcised) has constantly felt chaffed/burnt/hypersensitive/pain. I have to wear tight briefs instead of boxers because even the loose rubbing of boxers hurts. I have tried a few nerve blocks (pudendal and super hypogastric) with only temporary relief from the anesthetic. I also went to PT and was given desensitizing exercises which I feel only aggravated the situation. Obviously no STD's, I've tried every cream, and I'm currently on 20mg of Amitriptyline. Does anyone have a similar background? Chronic skin pain/chaffe/sensitivity from being too rough? Please, any help or guidance would be REALLY APPRECIATED:) I hope everyone is staying positive, what a great site/resource this is.

[Violet M]

Hi DM,

I've had the chaffed skin feeling, which I would refer to as allodynia, although my history is somewhat different than yours and being female the symptoms are somewhat different. But lot's of people with pudendal neuralgia complain about the chafing of underwear.

Violet

[make-it-stop]

I hope some of the guys will weigh in. I'm female, but had/have (just getting better from) long-term pudendal neuralgia. One of my symptoms was allodynia/hypersensitivity of the skin over the entire pudendal nerve area. It's gotten better as the nerve, itself, has calmed down. Did the doctor say what he thinks the specific issue is? Sounds like maybe irritation of the dorsal nerve branch of the pudendal nerve, and that's why the pudendal block worked diagnostically? My cause and problem with PN was totally different (tight muscles irritating all of my pelvic nerves), so unfortunately I doubt the treatment I've been having would work for you, but I just wanted to let you know of a couple things that helped with my pain while I was waiting for my PT to work. I don't know how bad your pain is and what it restricts you from doing (other than sex), but if it makes it difficult to work, you might be in need of more aggressive meds. I've been taking methadone starting a few months after my PN started. The reason for the methadone is because it helps with nerve-type pain. I started with a very small dose - 2.5mg once per day, and have gradually gone up to 5mg at a time, three or four times per day. The side effects are few and the payoff is good, but I was unable to sit at all without it, so you may not need something like this. One more thing you might want to research is central nervous system depressants (just don't depress it too much/don't overdose of course). I would take Xanax (0.25 or 0.5mg) if my symptoms were especially bad, even while lying down. Allodynia seems to be worse when the CNS is going overboard, so the Xanax would calm this down. BTW, I hear your not supposed to take methadone and Xanax together. I haven't died yet, but beware! Also, I'm sure one of the first things you tried was ice; it would help me as long as I had a papertowel or two around the ice pack - don't burn your skin with cold. One last thing - there's a kind of new-ish treatment that I was exploring trying earlier this year before I started to recover. It's called iovera, and is a form of cryotherapy. If you research it and are interested, I can give you the name of the iovera rep who seems to know which doctors are at the forefront of using it for the pelvic nerves. I also had a phone call with a neurologist/anesthesiologist down in Dallas who seemed really smart who has experience with pudendal nerve blocks and also with iovera (as of the call he hadn't done iovera on pudendal, but was willing to try; he might have done it by now). So let me know if you decide to explore that treatment so I can give you his info.