Is this pudendal neuralgia or TMS? Can I heal?

I'm a 42 year old woman who is active, happy, and youthful, though admittedly I have had a very stressful spring/early summer

I am hopeful some of you can provide some insight to my situation. After a mid-low spat of back pain (brought on, I think, from doing some skipping in an exercise class, on cement while in bare feet), I developed a UTI, though it wasn't found to be bacterial. I took antibiotics for a week, it felt cleared up, but a week later seemed like it was back -- so I did another round of antibiotics.

During the second round (and my apologies, this is TMI), I developed a very sore/raw clitoris - I've never had this before and it took me by surprise. I suffered with it a few days, and then thought maybe it was a yeast infection concentrated in this one place (from the earlier antibiotics). So, I treated for yeast infection and I'm now satisfied I don't have a yeast infection (I have zero symptoms of one).

The clitoris pain is distracting, but what is far more alarming to me is that my entire vulva region (including the clitoris) seems "numb/dead" -- like I have no sexual arousal at all, and it seems like the clitorial nub has shrunk. Nothing in that area gets engorged with blood, arousal etc. and I'm having trouble feeling like my mind is connected to this part of my body.

My ability to urinate and my bowel control seems totally fine. I've done a lot of "active release" of the fascia around my hips, IT band, and am working on my piriformis.

I'm also able to engage my pelvic muscles, I think, though the little muscle or nerve that lifts the clitoris hood seems "dead" as well.

This is all scary for me and I don't know where to turn. I went to a chiropractor but she didn't really address the sexual issue.

My boyfriend is back this weekend from a long trip away and I'm sure we will want to have sex -- but I feel like my body is unresponsive and my vaginal muscles may be compromised as well. We've always enjoyed a great sex life so this is unexpected and I'm stressed that I may never bounce back.

I have a history of TMS symptoms and cleared a major spell of back pain/sciatic in my early 20s through Dr. Sarno's work. I've been trying to apply his methods to this situation,but it seems maybe different?

Is it just TMS and I should relax? Can "dead" clitorisis and sexual parts rebound and become "alive" again?

I don't want to get a diagnosis of pudendal neuralgia as having injections and surgeries etc are not a road I wish to go down.

My body is otherwise healthy and I have good movement and range, etc. Not a lot of back pain, maybe a bit in my left glute and low back/SI area.

Any insight people here can share would go a long way to help me.

Thank you,
Moksha Moksha

 

So, your bladder symptoms could be similar to what they call "interstitial cystitis" or the newer name, "painful bladder syndrome". It was once believed to be an autoimmune thing, but for most people, it doesnt quite add up. My long term bladder pain is definitely TMS, and so is my pudendal neuralgia. I've had all the sore feelings you describe, though not the "dead" feelings. However, i'm sure it can happen. So this might be controversial to the TMS crowd, but many people have negative thoughts on physical therapy. Honestly, i've had both positive and non-results. Like, my wonderful PT is able to loosen the tense muscles temporarily, but it always returns. That's because she's only addressing muscle tension, but not the pain signals that come from the brain. However i do know that a recurring spasm can cause some of the issues you speak of. One time i attempted to do my own PT, and i accidentally jabbed my finger right into the pudendal nerve from the inside. This set off a horrid flare that lasted days with no end. I went to my PT and told her i did something bad. She went in internally, and released a spasming muscle and i got immediate relief. I had no more pain for years. It returned almost a decade later from a different trigger. So if you have the means to see a pelvic PT, it may help. Worst thing is that you pay for something that doesnt work.
In the meantime, like many people with chronic pain, i shied away from activity because i worried "worsening" the pain, and instead, it did a bad detriment to my mental and physical health. I also avoided sexual activity. Now for the most part, i continue to do all the things i love (unless in a very terrible flare) because avoidance only reinforces the "i'm broken" signal in the brain. Keep in mind as you try new things, dont approach them with worry. You need to approach them with confidence and joy. Learning to do activity while not fearing pain after, is very difficult. You almost have to go against your own insticts. For me though, that's how i got much of my life back. i stopped the obsessive "before and after" care when i did things....i just did things as if i never had the pain in the first place.

 

Thank you so much for your support, Nicole. Can I ask ("woman to woman") if you ever had clitoral pain, and if so, did you feel it was effected by the nerve? Did it subside, and did you regain sexual sensation?

 

yes, usually it felt like an annoying electrical pressure, or almost an uncomfortable arousal. Any part of my PN can get affected, from sacrum, all the way to the dorsal root. When the uncomfy arousal happens, i use my tens unit. I put the electrode on the pubic bone as low as i can, right above the "crack" if that makes sense. that blocks some of the uncomfortable feelings.

btw, i never had lack of sensation, if anything, i had "too much".