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There is no one cause of pudendal neuralgia. It may be related to: 1  Childbirth trauma. 2  Gynaecological or colo-rectal surgery. 3  Cycling. 4  Excessive physical exercise. 5  Past pelvic or perineal trauma. 6  Injury. 7  Straining.
If you have pain in the pudendal nerve distribution area and doctors cannot find a reason for it then you might have pudendal neuralgia. The pudendal nerve innervates the penis and clitoris, bulbospongiosus and ischiocavernosus muscles, and areas around the scrotum, perineum, and anus. (see anatomy section) The pain can be burning, stabbing, aching, or just a sense of numbness with loss of sensation.