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If you feel tingling in your genital area, you maybe be concerned about nerve damage, disruption of blood flow to the genitals, or sexual performance. A numb vagina or penis can be caused by cauda equina syndrome which is a rare disorder that affects the nerves located in the lower end of the spinal cord. This disorder can be either rapid onset, or slow onset. Read below for additional information on causes and treatment options for tingling genitals.
Genital numbness and tingling symptoms explained
Numbness in the genital or pelvic area can be described multiple ways — such as a loss of sensation, “pins and needles,” or “tingling.” It is a serious cause for concern as it often signals an underlying condition or problem with the nerves in that area that requires medical attention.
Common accompanying symptoms of genital numbness are
Genital numbness can be a problem for both men and women and can have associated symptoms including:
- Weakness in the pelvic area or lower extremities
- Numbness or similar sensations in the lower extremity
- Problems with bowel or bladder control
- Loss of lower extremity reflexes
Symptoms of sexual dysfunction
Sexual dysfunction may occur, including but not limited to:
- Inability to achieve an erection (impotence) or orgasm in a man or woman
- Erectile dysfunction in men
- Decreased libido: This is decreased sexual interest or desire.
- Ejaculatory issues: Such as premature or delayed ejaculation
Genital numbness and its associated symptoms can be very debilitating and affect the quality of life for many affected individuals. It is important to follow-up with your healthcare provider if you are experiencing any of the above symptoms.
What causes numbness and tingling in the penis or vagina?
Changes in sensation and numbness of the genital area are often the result of damage, compression or inflammation to nerves that branch from a collection of peripheral nerve roots that exit from the bottom of the spinal cord. This collection of nerves is known as the cauda equina. The cauda equina and its nerve roots are vital in providing innervation to the lower body that includes sensation, movement, and function of the lower body’s major organs including the organs of the reproductive system.
See a general image of the location of the cauda equina here.
The pudendal nerve is one of these many branches. It is the nerve that innervates the penis and clitoris and most of the skin in the genital area (also called the perineum). Isolated numbness of the genital area is most often directly related to damage or injury to this nerve.
It is important to make an appointment with your healthcare provider in order to get the appropriate diagnosis and care since genital numbness can be a complicated condition. The causes of genital numbness can be grouped into the following categories:
Direct traumatic injury to the pelvis area can occur in high-impact situations like motor vehicle or motorcycle accidents, but also in low-impact situations like falls in older or more frail individuals. The injuries that result in such traumatic situations can affect multiple components of the pelvic area, from bones to muscles and arteries to nerves . Often the nerve roots of the cauda equina are affected (this is called cauda equina syndrome), and in addition to numbness of the genital area, individuals with high-trauma pelvic injury may also experience back pain, loss of bladder function or control, loss of lower reflexes, weakness and numbness in other body parts. This is a medical emergency and requires prompt medical attention.
Causes of genital numbness related to compression may include the following.
- Mechanical: Anatomical problems in the way that the spine interacts with the nerves in the lower body can result in compression that may lead to symptoms of numbness. For example, a herniated disc or conditions such as spinal stenosis (when bumps form in the spinal vertebrae) can press upon or pinch the nerves as they exit. Mechanical issues can also arise from external forces. For example, cycling for long periods of time can result in compression of the pudendal nerve and its roots in men, often causing isolated numbness and impotence.
- Cancer: Tumors, benign or malignant, that grow or invade the lower spine can compress the nerves in this area resulting in the symptoms discussed above.
Inflammatory causes of genital numbness may include the following.
- Infectious: Many different types of infection, both viral and bacterial, can damage or irritate the nerves of the cauda equina roots. These infectious causes can affect the nerves directly or form spinal abscesses that may also lead to inflammation.
- Immune-mediated: Many inflammatory diseases that result in the body attacking itself can also affect the nerves and cause injury that results in numbness. Conditions such as Multiple Sclerosis and Lupus are examples of such autoimmune diseases.
This list does not constitute medical advice and may not accurately represent what you have.
Cauda equina syndrome (rapid-onset)
Although leg pain is common and usually goes away without surgery, cauda equina syndrome, a rare disorder affecting the bundle of nerve roots (cauda equina) at the lower (lumbar) end of the spinal cord, is a surgical emergency.
Rarity: Ultra rare
Top Symptoms: lower back pain, back pain that shoots to the butt, back pain that shoots down the leg, leg weakness, thigh numbness
Urgency: Emergency medical service
Lower back (sacral vertebral) fracture
A sacral stress fracture is a small break in the sacrum. The sacrum is a large triangular bone at base of the spine. The sacrum connects to the pelvis.
Top Symptoms: lower back pain, back pain that shoots to the butt, back pain that shoots down the leg, severe back pain, lower back pain from an injury
Symptoms that always occur with lower back (sacral vertebral) fracture: lower back pain from an injury
Urgency: Primary care doctor
When and how to treat numbness and tingling in the penis or vagina
Symptoms of genital numbness are always considered a medical emergency as the nerves arise from roots in close proximity to the spinal cord.
When to see a doctor
Even if your symptoms are isolated to only the genital area and are not persistent, make an appointment with your healthcare professional as soon as possible in order to investigate further.
Treatment will depend on the exact cause of your symptoms. Your physician may discuss the following treatment options with you such as:
- Surgery: Surgery is often a first-line modality for removing pieces of bone or discs in the spine that could be causing symptoms. Surgery may also be used for removal of some tumors that are causing compression.
- Cancer treatment: if your symptoms are the result of a compressive tumor, your physician may also discuss chemotherapy or radiation in addition to surgery.
- Medication: If your symptoms are due to infection or inflammation, your physician has a variety of medications such as antibiotics for infections, steroids for inflammatory conditions or more advanced treatments for conditions such as Multiple Sclerosis.
FAQs about genital numbness
How will my sexual function be affected given my genital numbness?
Genital numbness is often associated with significant sexual dysfunction in both men and women. Men may experience an inability to achieve erection or orgasm and issues with ejaculation. Women may experience similar symptoms in relation to the clitoris.
Is my bike seat causing my genital numbness?
Recent studies have shown that intense cycling can cause compression of the pudendal nerve, in addition to disruption of penile blood supply that may result in penile numbness and impotence. There is no data on which bike seats or what types of bike seats cause most of these symptoms; however, most studies suggest restricting training distance, pausing during prolonged and intense cycling, and standing frequently in order to avoid and prevent symptoms .
Are there things I can do at home to treat my genital numbness?
Always visit your physician first before taking treatment options for these symptoms into your own hands. Depending on your symptoms, it may not be safe to self-treat. However, if you notice your symptoms are related to activities such as bike riding or participating in triathlons, make efforts to reduce your participation in those activities.
Is my genital numbness a chronic problem?
Genital numbness may be chronic or acute depending on the specific cause. For example, in the case of a tumor, symptoms may progress slowly due to the slow-growing nature of some tumors. Symptoms of numbness may arise over time and the situation may be chronic in nature. On the other hand, a high-trauma injury will result in acute symptoms that occur soon after the injury. In either case, immediate treatment is necessary.
Is genital numbness a medical emergency?
Yes, numbness or loss of sensation in the pelvic area, especially after a very traumatic injury, necessitates immediate medical attention. This may be the first sign of cauda equina syndrome (damage to the nerve roots of the lower body that exit from the spinal cord). These nerves are very important to multiple functions of the lower body and immediate assessment of their integrity and appropriate treatment is key.
Dr. Gambrah-Lyles is a resident pediatrician at the Children's Hospital of Philadelphia. She is a graduate of the University of Pennsylvania Perelman School of Medicine (2019). She graduated cum laude and received her undergraduate degree in Biochemistry and Spanish from Washington University in St. Louis (2013). Her research explores the intersections between neurology, public health, and infectious disease. She has investigated nutrition and cerebral palsy in Botswana, and completed a year-long project in Brazil, researching growth and developmental outcomes of Zika virus infection in pediatric patients as a Doris Duke International Scholar. Dr. Gambrah-Lyles speaks four languages, loves staying active, and enjoys sharing her love for medicine through teaching and writing.
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