Most of us women at one time or another in our lives will see our doctor for treatment for a yeast infection. However, if you are someone who has “swore” you had a yeast infection, only to go to the doctor and have them tell you everything “looks fine”, or maybe you just self- treat frequently with over the counter meds for frequent burning and itchiness, then this post is for you! And, if you’ve ever had any “weird sensations” in your pelvis or vulvar area (see below) then this post is for you too!
While you may have heard of your pelvic floor, a group of muscles in your pelvis that are responsible for maintaining bladder and bowel control (among other things), most people don’t think much about the nerves that supply the area of your pelvis. Just like you can move the wrong way and irritate a nerve in your back, get carpal tunnel syndrome, or get compression of your sciatic nerve that can cause leg pain, the nerves in your pelvis can also become irritated!
One nerve in particular, the pudendal nerve, is responsible for supplying sensation to the clitoris, labia, and areas around the vagina and anus. In addition, the pudendal nerve also is responsible for innervating some of the pelvic floor muscles, including the urethral sphincter and external anal sphincter (which helps with bowel control). When the pudendal nerve or a portion of it, becomes irritated you may feel many different symptoms. You may feel like you have a yeast infection, are “on fire down there”, feel itchy, feel like your urethra is irritated, have clitoral pain ,experience shooting pains into your vagina, or feel like you have hemorrhoid, or feel like you are sitting on a “rock” to name a few.
So, how does the nerve get irritated? Irritation to the nerve typically happens either if the nerve is compressed, stretched, or restricted so that it does not glide normally. Nerve irritation can sometimes happen if you cycle a lot (which puts pressure on the nerve), with prolonged sitting, after working out, or after having sex. Childbirth can also stretch the nerve, causing it to be irritated. In addition, if you had an episiotomy or tore during childbirth requiring stiches, scar tissue can form, restricting the nerve and causing symptoms.
So, if you notice these symptoms, what can you do about it? Obviously if your burning or irritation is accompanied by unusual discharge, a fever or other symptoms you would want to seek out your health care provider for treatment as this could signal a potential infection. But, if no red flag symptoms exist and you feel the irritation may be more of the nerve variety, seek out a physical therapist certified in the treatment of the pelvic floor. Pelvic floor treatment includes helping to relax tight muscles that might be compressing the nerve, as well as massaging or mobilizing the tissue around the nerve to help it move more freely. Sometimes, patients will feel better immediately, and other times, it takes a few visits before the symptoms subside.
And what about all of the men who might be reading this? You have a pudendal nerve as well. Pudendal nerve irritation for you can cause pain in the penis, scrotum and around the anus as well as some difficulty with erection. If you think you may be having symptoms pelvic floor therapy may help you as well!
Written by: Kim Osler PT, DPT, WCS