Health Organization for Pudendal Education

Just looking for a bit of guidance and knowledge here. Could having a tight pelvic floor be causing my PGAD? Or could it be the nerve causing a tight pelvic floor?

I'm thinking it's the first as my symptoms started after sex.

Any help would be appreciated.

Hi,

This is one of the hard questions when it comes to PN pain/PGAD. It seems that both situations are possible. If your nerve is unhappy it can cause your pelvic muscles to tighten in response. If your pelvic muscles are too tight, this can cause nerve pain or unwanted nerve sensations such as PGAD.

Sincerely,
Stephanies

Hey
Thanks for the response

I feel that if I can totally relax, my symptoms get almost non existent so I'm going to see a pt and see what happens.

Thanks again.

This is just really getting me down today. I just want it to end.

I agree with Stephanie. I think it can be hard to tell whether it's the muscles or the nerves that are the issue but I have a theory based on my experience. I could be wrong but I think one possible way to tell whether it's the nerve causing the tight pelvic floor or the other way around is to try myofascial release from a good PT and see what happens. If it helps and doesn't cause a flare-up, then it might just be tight muscles but if you have a major flare-up and you have pain along the course of the pudendal nerve when the therapist presses on the nerve, that could mean the nerve is damaged. At least that is what happened to me. I had an extremely tight pelvic floor but internal myofascial release did not help at all. Instead it caused a major flare-up for a week and pressing along the course of the pudendal nerve was very painful. After I had PNE surgery to release the nerve and the nerve had some time to heal, I was able to relax the pelvic floor and could tolerate myofascial release.

Violet

I saw pelvic PTs in 2005-2007 off and on and have recently started PT again. I personally have seen a great deal of change in the approach of PTs over the years in a positive way. Years ago, the PTs I saw seemed to jump into aggressive internal work only on specific muscles. It seems now the approach is more comprehensive with a lot of external work and focus on muscles other than those in the pelvis that can contribute to pelvic pain. For example, my current PT does a lot of work on my hamstring and adductor muscles and also is trying to work to mobilize scar tissue from my surgeries. I am not sure if any of this will be successful or translate into lower pain levels (I have seen my current PT about 8 times), but I will keep you posted. I hope that PT will help you.

Got my doctors appointment on Wednesday. Just a bit apprehensive about what going to be said. I've had a good 5 days in a row with barely any symptoms so I'm hoping this is a very positive sign. I know this might be tmi but I've been able to orgasm without having making my symptoms worse. I've also developed itching down there. Doesn't happen everyday. I'm hoping things are on the up. Thanks for all your support so far. Really appreciate it.

Bloody doctor didn't refer me for PT. instead I've been referred for CBT and to a dietician as they reckon it's anxiety and stress related and that my ibs isn't helping. What do you think of that? Sound promising?

Well, I guess I'm not surprised because I was referred to a psychiatrist. I was also told by a therapist to snap a rubberband against my wrist to distract myself from the symptoms. So, I don't know -- do you think your symptoms are the result of anxiety? For me, anxiety had nothing to do with it but everyone is different. Other people have posted in the past that CBT was helpful to them so it may be worth a try.

Violet