Health Organization for Pudendal Education

There was somebody on the other forum, Michael J., who posted about a first outbreak of herpes bringing on pudendal nerve pain. If you google postherpetic pudendal neuralgia, there is one paper on it (but you would have to go to a library to have them get you a copy of it). This is not something you would pursue nerve decompression surgery for; it's something you would try to manage by medication. I don't know what dose of Valtrex you're on, but maybe you could ask about a higher once since you are having this trouble. Other medications people here take to cope with nerve pain are Neurontin, Elavil, Lyrica, Klonopin, Valium, and Cymbalta. Sometimes a combination is needed to get good control. It's not a simple answer in that you may need to ramp up to the right dose on them, or taper down, or find that there are side effects like fatigue or fogginess or impaired sexual response. But, if it can help you manage your pain when nothing else will, it lets you get back to living. Most people who use meds for nerve pain do eventually find something that helps.

Hi Molly Sue,
I had an outbreak of herpes (on my buttock) one and a half years ago that left me with ongoing post herpatic pain. I was orignally diagnosed with herpes 25 years ago when I was pregnant with my daughter. Until now I have not had an outbreak. I have also found out through a pelvic MRI that there may be a problem with the coccyx bone and branch of the pudendal nerve that leads to the anus. To manage the pain I have been on lyrica since that time. I've gone up on the dose to the max amount of 450 mg with good results most days. There are side effects though. I have not been able to find the correct diagnosis yet. My doctor would like me to have an epidural although I understand it could make the pain worse if in fact it is caused by the herpes virus. So I have not agreed to have this done. I am considering a block at the sight where the coccyx bone impinges on the branch of the pudendal nerve.

I hope you are able to find the right doctor to treat your condition and prescribe the right medication to ease you pain and discomfort.

Take Care,
Patti