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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.