As definitive causes of vulvodynia still remain unknown, there is yet a lot of room for speculation as to what the true reason of this condition is.

One of the culprits that you might not have heard of is pudendal neuralgia – a condition that surprisingly causes very similar (and sometimes identical!) symptoms to vulvodynia.

If you are still looking for definitive answers as to what is to blame for your vulvar pain then this blog post will help you find out if your vulvodynia and pudendal neuralgia are intertwined.

Pudendal Neuralgia

Pudendal neuralgia (PN) is a chronic pain condition caused by malfunction of the pudendal nerve.

Pudendal Nerve

The pudendal nerve is often linked to agonizing chronic vulvar pain as it is the main nerve that runs through the pelvic area.

The pudendal nerve is responsible for providing sensation, muscle function and carrying pain signals to the spinal cord and brain from your:

  • Vulva
    • The clitoris
    • Mons pubis
    • Labia
  • Urethra
  • The base of the bladder (sphincter muscles)
  • Anus (sphincter muscles)
  • Inner buttock
  • Perineum (the area between your anus and vulva)
  • The lower outer third of the vagina

Pudendal Neuralgia Causes

Pudendal neuralgia can be caused by pudendal nerve trauma such as:

  • Entrapment
  • Compression
  • Restriction
  • Injury
  • Irritation
  • Inflammation
  • Dysfunction

For a full list of pudendal nerve trauma sources, please tune into the upcoming post, “The Complete Guide To Pudendal Neuralgia.”

For a full list of pudendal nerve trauma sources, please tune into the upcoming post, “The Complete Guide To Pudendal Neuralgia.”

Pudendal Neuralgia Symptoms

Symptoms of pudendal neuralgia are very similar to vulvodynia symptoms and are described as intense pain, discomfort or numbness in the pelvic region (in and around the pudendal nerve area).

Types of pain

  • Stinging
  • Burning
  • Stabbing and knife-like
  • Aching
  • Electric shock
  • Shooting

Types of sensations

  • Tightness
  • Numbness, tingling, pins, and needles
  • Twisting or pinching
  • Crawling on the skin
  • Irritation
  • Cramping and spasm
  • Hypersensitivity to touch or pressure
  • Itching
  • Raw feeling
  • Abnormal temperature sensations
  • A swollen feeling
  • Hot sensation

Vulvodynia and Pudendal Neuralgia

Similarly to vulvodynia, pudendal neuralgia is not an uncommon pain condition.

It is also often unrecognized and misdiagnosed by the majority of physicians, including specialists experienced in pelvic pain such as gynecologists, urologists, and neurologists.


The first reason is that pudendal neuralgia often shares almost identical symptoms with other conditions like vulvodynia. These conditions frequently mirror symptoms of pudendal neuralgia or are actually caused by it.

The second reason is that vulvar, perineal and peri-rectal affected tissues either appear completely normal or only mildly abnormal – which makes this condition also mostly invisible.

For a full list of other conditions and syndromes intertwined with pudendal neuralgia, please tune into the upcoming post, “The Complete Guide To Pudendal Neuralgia.”

For a full list of other conditions and syndromes intertwined with pudendal neuralgia, please tune into the upcoming post, “The Complete Guide To Pudendal Neuralgia.”

So, what is the difference between vulvodynia and pudendal neuralgia, you might ask?

Pudendal neuralgia is often the source of chronic pelvic and vulvar pain. Vulvodynia and pudendal neuralgia symptoms can be very similar, sometimes even identical.

However, there are at least 24 signs that are good indicators and can help you to initially determine if your vulvodynia is possibly caused by pudendal neuralgia (or any problem connected to the pudendal nerve).

24 Signs Your Vulvodynia Might Be Caused by Pudendal Neuralgia

#1. Your pain lessens when you sit on the toilet seat or doughnut pillow, which reduces the pressure on the pudendal nerve
#2. Prolonged sitting makes your pain worse
#3. Your pain is often not immediate but delayed and then stays long after discontinuation of the activity that caused the pain in the first place (like sex, sitting, cycling, etc.)
#4. You feel friction or inflammation along the nerve when you walk or run for too long
#5. Your pain is often lower in the morning, or even nonexistent (upon awakening) and increases throughout the day
#6. You can’t tolerate tight pants or elastic bands around your legs
#7. You have lower back pain from radiation of the pain
#8. You have pain in the perineum
#9. You experience numbness, coldness, burning sensations in your legs, feet, buttock, often due to a reaction of the surrounding muscles to the pain in the pelvic region
#10. You feel extreme pain or tenderness along the nerve during a pelvic or rectal exam
#11. Skin in the nerve area is hypersensitive to touch or pressure
#12. You feel like there is a lump or foreign body in your vagina or rectum
#13. You feel like you need to pee constantly even when your bladder is empty
#14. You have difficulty starting the flow of urine
#15. Your urethra is burning during and after urination
#16. You need to strain and push to empty your bladder
#17. You feel like your bladder is irritated
#18. You have painful muscles spasms of the pelvic floor before and after having a bowel movement
#19. You suffer from constipation
#20. You feel pain or burning before and after pooping
#21. You feel pain during and after sex
#22. You feel pain after orgasm
#23. You have a strange feeling of uncomfortable arousal without sexual desire
#24. You experience loss of sensation and difficulties achieving orgasm

Tips for Better Results


Conscious Attention

To truly determine if any of the above 24 signs are related to your pain, you will need to pay more conscious attention to the type, intensity, and duration of your pain.

Pain Diary

Also, to keep track and better remember the results, it is a good idea to equip yourself with a pain diary. A pain diary will allow you to better monitor the levels and triggers of your pain over a longer period of time.

Next Steps After Your Initial Self-Diagnosis


Talk to Your Doctor

If you have any suspicions that your vulvodynia might be caused by pudendal neuralgia, please after this initial self-diagnosis, talk to your doctor. He/she will assist you with further diagnosis and recommend possible steps that you can take to confirm or rule out this possibility.

Learn More About Pudendal Neuralgia

If you want to dive deeper into the topic to have even more information, please tune into the upcoming post, “The Definitive Guide to Pudendal Neuralgia”, which will provide you with more in-depth insights about this condition.


In this post, you can find initial information about:

  • What are pudendal neuralgia and pudendal nerve
  • What are the symptoms and causes of pudendal neuralgia
  • How vulvodynia and pudendal neuralgia can be interwind
  • List of 24 signs that can help you to determine the source of your chronic vulvar pain

Hey, Vulva Warriors!

Are you someone whose chronic vulvar pain is caused by pudendal neuralgia? How do you manage it? How did you find out that your vulvar pain is caused by pudendal neuralgia? Which doctor(s) helped you to diagnose this condition and go through it? Would you like to share your personal insights to help others through their tough journey?

If you would like to share your thoughts, experiences, and questions or simply say hi, please feel free to contact me through the comment section below, on FB or at community@meandmyv.com.

Hello, Health Professionals!

If you are a health professional that deals with pudendal neuralgia as a cause of vulvar pain and you would like to share your experience, cooperate, simply connect or drop a question, please feel invited to contact me through the comment section below, on FB or at community@meandmyv.com.


My goal is to provide you with the most relevant and current information that is factually correct, comprehensive and up-to-date.

However, the information provided herein might be subject to changes and is not intended to cover all possible:

  • Pudendal neuralgia symptoms and causes
  • Signs indicating that vulvar pain is caused by pudendal neuralgia

Additionally, each person is different and may respond differently to different pain triggers.

Please also bear in mind, that this article should not be used as a substitute for the knowledge and expertise of a doctor or other licensed healthcare professionals. Please, before taking any medication, consult with your health provider who knows your medical history.


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