From the Research
Yes, pudendal neuralgia can cause pain after orgasm. This condition involves damage or irritation to the pudendal nerve, which supplies sensation to the genitals, perineum, and anal region. Post-orgasmic pain occurs because orgasm involves intense muscle contractions and increased blood flow to the genital area, which can aggravate the already irritated or compressed pudendal nerve.
Treatment Options
Treatment typically includes a multimodal approach with medications such as gabapentin (300-1200 mg three times daily), pregabalin (75-300 mg twice daily), or amitriptyline (10-75 mg at bedtime) 1. Physical therapy focusing on pelvic floor relaxation techniques is often beneficial. Nerve blocks with local anesthetics and corticosteroids may provide temporary relief, as discussed in a 2022 study on the utilization of pudendal nerve blocks for treatment of pudendal neuralgia 2. Lifestyle modifications like avoiding prolonged sitting, using cushions designed for pudendal neuralgia, and applying ice or heat can help manage symptoms.
Impact on Quality of Life
The condition can significantly impact sexual function and quality of life, so working with healthcare providers specializing in pelvic pain is important for proper diagnosis and treatment. A 2021 systematic review highlights the role of pudendal neuralgia in sexual dysfunction, including erectile dysfunction, premature ejaculation, and vulvodynia 3. A 2025 systematic review and meta-analysis found that all treatments, including surgery, injections, and pulse radiofrequency treatments, appear to provide relief to a similar extent, but no treatment was clearly superior for pain relief 4.
Key Considerations
- Pudendal neuralgia is a chronic condition that requires a comprehensive treatment approach.
- A step-ladder approach to therapy is suggested when treating these patients, as described in a 2014 study on pudendal neuralgia 5.
- Healthcare providers should be aware of the potential for pudendal neuralgia to cause sexual dysfunction and examine the pudendal canal in patients with these symptoms.