Pudendal neuralgia is the most common and most disabling form of pelvic pain. It presents as unilateral or bilateral burning pain of the anterior or posterior perineum that is worse on sitting and relieved by standing, not usually associated with night pain. This pain is a cause of chronic, disabling, and often intractable perineal pain. Treating this pain is very difficult.
Pelvic pain due to pudendal nerve entrapment
The authors report a case of a 40-year-old man presenting with chronic pelvic pain due to pudendal nerve entrapment, successfully treated with our body-own analgesic palmitoylethanolamide (PEA). Their hypothesis of its mechanism of action in this ailment is:
PEA may induce relief of neuropathic pain through an action upon receptors located on the nociceptive pathway as well as a more direct action on mast cells via an ALIA (autocoid local injury antagonism) mechanism. [1, 2, 3]
They conclude stating that: the present case suggests that PEA could be a valuable pharmacological alternative to the most common drugs (anti-epileptics and antidepressants) used in the treatment of neuropathic pain.
PEA can be obtained worldwide as the supplement PeaPure, produced in the Netherlands under GMP conditions. Most double blind studies are performed with pure palmitoylethanolamide, and it is due to the work of the Nobel laureate Levi-Montalcini that pure palmitoylethanolamide became into the focus of interest. In PeaPure there is only pure PEA, no chemical or pharmaceutical excipients. Normast contains such chemical excipients.
PeaPure is produced under GMP conditions in the Netherlands and can be shipped worldwide.
Dose recommendations for pelvic pains
Take 1200 mg PEA each day, for instance two capsules PeaPure in the morning and one in the evening, increase dose after 6 weeks if nothing is noticed yet to twice daily two capsules (1600 mg/day), or start a 10 days regime of taking the 400 mg PEA from a capsule via a spoon under the tongue and let it slowly melt there. If after 8-12 weeks painkilling effects are minute or absent, stop, if the pain is reduced more than 50% continue with 400 mg PEA less for another 2 months, and slowly try tapering off. If pain increases again, increase the dose.
: 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 May;11(5):781-4. Epub 2010 Mar 22.
: Aloe L, Leon A, Levi-Montalcini R. | A proposed autacoid mechanism controlling mastocyte behaviour. | Agents Actions. | 1993;39 Spec No:C145-7.
: Darmani NA, Izzo AA, Degenhardt B, Valenti M, Scaglione G, Capasso R, Sorrentini I, Di Marzo V. | Involvement of the cannabimimetic compound, N-palmitoyl-ethanolamine, in inflammatory and neuropathic conditions: review of the available pre-clinical data, and first human studies. | Neuropharmacology. | 2005 Jun;48(8):1154-63.