Anatomy Nerves The Anatomy of the Pudendal Nerve This nerve provides sensation and movement to the pelvic region By Adrienne Dellwo Adrienne Dellwo LinkedIn Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. Learn about our editorial process Updated on February 26, 2022 Medically reviewed by Nicholas R. Metrus, MD Medically reviewed by Nicholas R. Metrus, MD LinkedIn Nicholas R. Metrus, MD, is a board-certified neurologist and neuro-oncologist. He currently serves at the Glasser Brain Tumor Center in Summit, New Jersey. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Anatomy Function Associated Conditions Rehabilitation The pudendal nerve is the main nerve that serves the perineum, which is the area between the anus and the genitalia (the scrotum in men and the vulva in women). It carries sensory information (sensation) from the external genitalia and the skin around the anus and perineum. Additionally, it transmits motor signals, which cause movement, to several pelvic muscles. Anatomy The pudendal nerve is the second lowest of the 31 spinal nerves. All spinal nerves are paired but generally are referred to as a single nerve and, when necessary, differentiated by the side of the body they serve. The spine is divided into five regions. From top to bottom, these regions are: Cervical Thoracic Lumbar Sacral Coccygeal Five nerves, including the pudendal nerve, emerge from the spinal cord in the sacral region and just one from the coccygeal region below it. The sacral region begins just below the top of your pelvic bone and ends just above your "tail bone," or coccyx. The sacral nerves are: Superior gluteal nerve (S1) Inferior gluteal nerve (S2) Sciatic nerve (S3) Posterior cutaneous nerve (S4) Pudendal nerve (S5) Structure The pudendal nerve divides into three main branches, which are the: Inferior rectal nervePerineal nerveDorsal nerve of the penis or clitoris These nerves, in turn, divide into more parts as they connect to different muscles and other tissues. Location After branching out from the spinal cord, the pudendal nerve's path resembles a rough "C" shape. It passes between the coccygeus and piriformis muscles, which are deep in the buttocks and behind the gluteus maximus. It then leaves the pelvis through an opening in the bone called the greater sciatic foramen, crosses over the sacrospinous ligament, then goes back inside the pelvis via the lesser sciatic foramen. It then runs through a sheath of fascia (connective tissue) that's called the pudendal canal. That's where it divides into the inferior rectal, perineal, and dorsal nerves. Dean Mitchell / Getty Images Function The pudendal nerve has motor and sensory functions in the pelvis and plays an important part in both sexual function and continence. Motor Function Nerve signals from the brain are what moves your muscles. The pudendal nerve transmits signals to various muscles in the perineum and the pelvic floor, including: BulbospongiosusIschiocavernosusLevator aniExternal anal sphincterExternal urethral sphincter Sensory Function The pudendal nerve provides sensation to the: PenisPosterior scrotumClitorisLabiaAnal canal Other nerves provide sensation to these areas, as well. Role in Sexual Function The pudendal nerve sends signals to the central nerves system that are involved in both penile and clitoral erection. It's also responsible for male ejaculation. Associated Conditions The condition most often associated with this nerve is pudendal neuralgia, which is pain resulting from nerve damage or entrapment. This can lead to chronic pelvic pain, which can be severe. Causes of pudendal neuropathy include: Trauma due to childbirth Gynecological or colo-rectal surgery Other trauma to the pelvis and/or buttocks Diabetic neuropathy Excessive sitting on a hard surface, as with cyclist's syndrome Excessive physical exercise Thickening of ligaments in the region Bony formations putting pressure on the nerve Chronic constipation Poor posture Stress Symptoms of pudendal neuropathy are felt in the genitalia, urethra, perineum, anus, or rectum. They include: Pain that is burning, shooting, aching, or like an electric shockItching or raw feelingSexual dysfunction and/or pain during intercourseDifficulty sittingBladder pain or dysfunctionBowel pain or dysfunctionA full sensation in the rectum or vagina (rarely)Pain while sitting but not while standingPhantom pain in the buttocks, legs, and feet due to sensation there being supplied by nearby spinal nerves Rehabilitation Treatment depends largely on the cause of your pudendal neuropathy. It may include any combination of the following: RestSitting on a "donut" cushionNerve blocks (which may also be used as a diagnostic tool)Anticonvulsant or antidepressant medicationsNerve decompression surgery Understanding Peripheral Neuropathy 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Origoni M, Leone Roberti Maggiore U, Salvatore S, Candiani M. Neurobiological mechanisms of pelvic pain. Biomed Res Int. 2014;2014:1-9. doi:10.1155/2014/903848 Kaiser JT, Lugo-Pico JG. Neuroanatomy, spinal nerves In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019. Updated May 22, 2019. Possover M, Forman A. Voiding dysfunction associated with pudendal nerve entrapment. Curr Bladder Dysfunct Rep. 2012;7(4):281-285. doi:10.1007/s11884-012-0156-5 Calabrò RS, Gervasi G, Marino S, Mondo PN, Bramanti P. Misdiagnosed chronic pelvic pain: pudendal neuralgia responding to a novel use of palmitoylethanolamide. Pain Med. 2010;11(5):781-784. doi:10.1111/j.1526-4637.2010.00823.x Ünlü Z, Yentur A, Çakil N. Pudendal nerve neuropathy: an unknown-rare cause of pelvic pain. Arch Rheumatol. 2016;31(1):102-103. doi:10.5606/ArchRheumatol.2016.5727 Women's Health & Research Institute of Australia. Pudendal neuralgia. Additional Reading Pudendal nerve. Healthline. Medicine Imaging: Pudendal Nerve Block. University of Rochester Medical Center. By Adrienne Dellwo Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit