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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.
More in Chronic Pain. The pudendal nerve runs through the gluteus muscles (the buttocks) and into the perineum (think of the perineum as any part of the body that touches a bicycle seat). Pudendal neuralgia (also known as pudendal neuropathy) is a disorder of the pudendal nerve that can lead to chronic pelvic pain. This condition may be caused by pudendal nerve entrapment, when the nerve becomes compressed, or by damage to the pudendal nerve itself and is also known as pudendal neuropathy. Causes Chronic pelvic pain from pudendal neuralgia can be caused by any of the following: 1  diabetic neuropathy. 2  trauma to the buttocks or pelvis including childbirth. 3  excessive sitting (cyclists often have pudendal nerve entrapment) 4  thickening of ligaments around the pudendal nerve. 5  bony formations pushing against the pudendal nerve.