Health Organization for Pudendal Education

On December 15th 2011 I noticed a drastic drop in libido and sexual function. I immediately suspected this was from all the cycling I do. I stopped cycling but the symptoms persisted. In March 2012 I had my testosterone tested. It was 250 ng/dl. That is really low. Normally a person my age should have six or seven hundred ng/dl. My Endo said it would be best to wait to see if I improve before starting HRT. Months went by and I had improved a little. In winter 2012 I had 0% sex drive. In the Spring it was 25%. In the summer and fall it was 75%. Things were okay but not how I used to be. Now it is back to 0%. Some people have suggested it might be vitamin d deficiency. I need to have that checked.

My first tests were of my testosterone, and LH. He noticed that my LH was low. That is strange because normally when testosterone goes down, LH will go up. Higher LH is the brains signal to the testes to make more testosterone, but my testosterone is low and so is my LH. My Endo called this idiopathic. He doesn't know what is causing my low T. I asked my Endo if there are any drugs which raise LH. That would raise my T. He said he had heard of such drugs but had never prescribed them himself. He didn't know anything about them. He is not a very good Endo. Unfortunately he is the only one I can afford. I have since discovered several different drugs such as HCG and Clomid which raise LH. I have learned from message boards, and not from my Endo, that continued HRT will destroy my body's ability to make its own testosterone. Also it will make me infertile. I have been on HRT for a month. Hopefully this is not long enough to cause any irreversible effects. The funny thing is the HRT does not even seem to be dong anything. I thought that even if my penis was not working at all the testosterone would still work on my brain and make me horny. I have not noticed any difference since starting HRT a month ago.

Lately I have noticed a patch of numb skin on my right hip. This made me start to wonder if this is a nerve condition. I did some searches and I found this website. I think I have PNE. It makes a lot of sense. My pudendal nerve must be damaged or entrapped. My conditions came on very quickly. I was fine one day and three days later I could not have sex at all. I don't have any pain. The only numbness I feel is an 8 inch wide part of my hip. I have feeling all over my scrotum and perineum. I did notice I have a little bit of urinary incontinence. I have not been horny in months. I have almost forgotten what passion and desire feels like. I am guessing that the nerve I pinched somehow shut down the production of testosterone.

I am not a doctor but this is what I am guessing. Maybe the nerve to my penis is fine. I can get erections and orgasm, but I am not as hard as I used to be. Most of the time orgasm I am only 75 percent hard. This is not hard enough to have sex. I rarely have morning erections. I never become aroused just by thinking about things. Maybe the PNE stopped my testes from producing testosterone and my ED is a result of low T.

if I have PNE I could get surgery and be cured.

What do you guys think. Thank you for your help

Hmm if you had PNE, you would know based on symptoms. If you're afraid of PNE, its probably best to stop cycling before a specialist can assess you or use a perineum friendly seat for the future if you don't have PNE. I have low testosterone as well (doesn't bother me so much), the endocrine system is primarily hormonally controlled through a negative feedback mechanism. From what I learned in university bio/physio and mcats (I'm not qualified), I don't see how a possible nerve entrapment down below would affect your hormone levels since the entire HTPA axis is regulated by negative feedback hormone mechanisms. How is your fat intake/sleep/stress levels? Clomid / HCG I remember from my bodybuilding days, but I just considered those bro-science lol. They can cause other issues.

A telltale sign of PNE is not being able to sit down, though sitting down on a toilet would relieve your problems. It would consistent of perineal/perianal sensitivity or numbness or pain. And generally the nerve need not be entrapped, it can just be irritated by muscles or misalignments causing stretching/compression of the nerve. Just take care of yourself, relax. Sometimes stress can cause tension in muscles that can adversely affect the pelvic environment.

Let me know what you find, I'd be interested to know. I have the same libido and erectile symptoms as you but I also cannot sit down and I've had stabbing pains in the perineum and but that sent me to a hospital for false flag cauda equina (I have a L5 S1 bulge in the mix). From my totally unqualified opinion, I think your symptoms probably have more to do with stress and hormones than with a pudendal nerve entrapment - PNE will cripple you as it's crippled me at the moment. You can still take measures in avoiding it or preventing it because it's definitely something you don't want to have lol...I'm hoping mine is just pelvic muscle hypertonicity.

Hi there - would just comment that the pudendal nerve does not innervate the hip, so the numb area there cannot be due to PN. I don't think we've ever encountered anyone where there has been a hormonal disturbance due to pudendal nerve damage. If you have no pain or numbness or altered feeling of any sort in the pudendal distribution, then it would be surprising if the pudendal nerve is the culprit here.

Does your endocrinologist suspect a neurological involvement with regard to the incontinence? I do hope that you get this sorted out soon.

Agree with the others. Maybe stopping cycling may help the numbness but couldn't really say what could be causing that but it won't be pudendal. Hope you get some answers to the problem and everything comes right again.
Take care,
Helen.