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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.
Pudendal Neuralgia and Pelvic Pain. Iâm currently at a conference on chronic pelvic pain here in Tacoma, WA. It is amazing how many causes of chronic pelvic pain there are; infection, endometriosis, pelvic muscle imbalances, gastrointestinal causes, joint pathology, etc. There are literally dozens of causes of chronic pain in this region. One of the rarer causes of chronic pelvic and genital pain is a disease called Pudendal Neuralgia. I have treated many patients over the past few years with this diagnosis, and it has been professionally rewarding for me.