Do you also experience severe, burning pain in your lower abdomen, that is, around your genitals and anus, when you sit down? Or do you have difficulty controlling your urine and stool, or do you feel a lack of sensation during sex? Although there are many reasons for such things, perhaps the cause is a problem with a special nerve that you have never heard of. Today we are talking about a very important, but not very talked about, part of our body, the pudendal nerve.
Simply put, what is the pudendal nerve?
Think of our body as a complex electrical circuit. The brain and spinal cord are the main powerhouses. From there, there is a network of 'electrical wires' that carry messages to every corner of the body. In a similar way, the pudendal nerve is like a major 'electrical wire' in our pelvic region.
This nerve carries sensation and motor messages to our genitals, anus, and surrounding areas. Strictly speaking, this nerve is part of our body's peripheral nervous system. That is, its main function is to carry commands from the brain and spinal cord to the relevant organs and to carry the sensations received from those organs back to the brain.
What are the most important things that happen to our body through the pudendal nerve?
The functions of this nerve can be divided into two parts. One is movement control , and the other is sensation . To explain this further, let's look at the table below.
| Job type | What happens is simply... |
|---|---|
| Motor Function | This nerve controls the sphincter muscles that help us pass stool and urine when we need to. If this nerve is damaged, this control can be lost. |
| Sensory Function | This nerve transmits sensations such as touch, pain, pleasure, and temperature to the brain. For example, healthy functioning of this nerve is essential for experiencing sexual pleasure. |
Where do these sensations occur?
The pudendal nerve mainly supplies sensation to the following areas:
- Men: Penis
- In women: Vagina and surrounding areas
- For both sides: Anus and Anal Canal, and the skin between them (Perineum)
Where is this nerve located in our body?
There are two separate pudendal nerves on the left and right sides of our bodies. This nerve starts at the vertebrae at the very bottom of our spine, at the end of the spinal cord. We call this area the Sacral Plexus. It's like a junction where a lot of telephone wires come together.
The pudendal nerve, which begins here, makes a very complex journey through the pelvic bones and gluteal muscles. On this journey, it passes through small openings between the bones and small tunnels between the muscles (Alcock's canal), and finally reaches its destination, the genitals and anus.
During this journey, the pudendal nerve divides into three main branches, each of which performs a specific function.
| Nerve Branch | Its main function |
|---|---|
| Inferior rectal nerve | Activates the anal sphincter, the muscle that controls bowel movements, and provides sensation to the rectum. |
| Perineal nerve | It functions to activate the pelvic floor muscles and the urethral sphincter, as well as to provide sensation to the skin around the labia in women and the scrotum in men. |
| Dorsal nerve | Providing sensation to the skin of the penis in men and the clitoris in women. This is essential for sexual pleasure and erection. |
How can the pudendal nerve be damaged or cause problems?
Pressure or damage to this nerve can cause neuropathy or severe pain.
Imagine what happens if this nerve gets pinched somewhere along the way? Just like when a water pipe gets pinched, the water stops flowing. When the nerve gets pinched, the transmission of messages is disrupted, causing severe pain. This is what we medically call Pudendal Nerve Entrapment Syndrome .
The chronic, stabbing pain caused by this condition is called pudendal neuralgia . Although it is not a common condition, it can be so painful that the sufferer is unable to perform even daily activities.
Common causes of nerve damage:
- Accidents and injuries: Accidents to the pelvic area.
- Surgery: Complications after surgery in the pelvic area, for example, prostatectomy or pelvic organ prolapse surgery.
- Diabetes: Uncontrolled diabetes can cause nerve damage.
- Childbirth: During a particularly difficult delivery, the baby's head can put pressure on the nerve.
- Prolonged pressure: Activities such as cycling for long periods of time can cause the nerve to become compressed. The saddle of the bike presses directly on the area where this nerve travels.
- Radiation Therapy: Radiation therapy given to the pelvic area for cancer.
- Tumors or Cysts: Nerve compression caused by a tumor that forms near the nerve.
How is this nerve important during childbirth?
A pudendal nerve block is a method of anesthesia that is given to an expectant mother to reduce the pain of childbirth. This involves injecting an anesthetic into the pudendal nerve, temporarily numbing the vagina and surrounding area.
This is usually used to reduce pain during the second stage of labor, when the baby is coming out. It is also sometimes used to numb the pain of an episiotomy, which is a cut between the vagina and anus. However, it is important to remember that this does not eliminate the pain of contractions.
How do we protect this important nerve?
There are a few simple steps we can follow to keep our entire nervous system healthy and protect the pudendal nerve.
- Don't sit in the same position for long periods of time, especially on hard surfaces. Get up and walk around at least once an hour.
- If you are a cyclist, take frequent breaks. Also, use special 'padded' seats that reduce pressure on the nerves.
- Manage stress. Relax your mind through meditation, walking, etc.
- Eat a healthy diet and maintain a healthy weight.
- Manage medical conditions like diabetes and high blood pressure well. These can damage the nerves.
- Avoid smoking. Smoking impairs blood supply to the nerves.
If you have these symptoms, definitely see a doctor.
If you are experiencing one or more of the following symptoms, it is very important not to ignore them and to consult your doctor as soon as possible.
| Symptom | What to pay attention to |
|---|---|
| Chronic pelvic pain | Persistent pain, tingling, or burning sensation in the genitals, anus, or surrounding area. |
| Pain that increases when sitting | If the pain worsens when you sit and decreases when you stand up and walk. |
| Sexual dysfunction | Pain during sex, decreased or loss of sensation, difficulty reaching orgasm. |
| Urinary/fecal incontinence | Passing small amounts of stool or urine without realizing it, or feeling the need to urinate/defecate frequently. |
The pudendal nerve is a vital nerve for sensation and movement in our pelvic area. Therefore, the pain and discomfort caused by damage to this nerve can severely affect your quality of life. Therefore, it is very important to be aware of these symptoms and seek medical advice if necessary.
Take-Home Message
- The pudendal nerve is the main nerve that controls sensation and movement in your pelvic area, genitals, and anus.
- Healthy functioning of this nerve is essential for bowel and bladder control, as well as sexual function and sexual pleasure.
- Increased pelvic pain when sitting can be a key symptom of a problem with the pudendal nerve.
- This nerve can be damaged due to causes such as accidents, surgery, childbirth, and riding a bike for long periods of time.
- If you have any of the symptoms mentioned in this article, do not ignore it and see your doctor as soon as possible for proper advice and treatment.
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