I can’t go into the details fully but 6.5 years ago developed pgad from a mixture of ativan taper getting rocky at the end and trying Trazadone for sleep but it settled to just mainly anal area luckily. I only had penis issues the very first week.
Nothing helped then after two years pain developed but very lateral and my symptoms didn’t totally match pn. I discovered the perineal branch of the posterior femoral cutaneous nerve was my problem. One block was so successful that i was considering a neurectomy to help my sitting pain and help pgad. One last block caused a severe pain flare and they put me on cymbalta even though it made it worse in the past. I thought maybe give it time. Pain control good, pgad horrible and was drinking alcohol daily to cope.

Did a foolishly rapid taper in June after 7 months on pill and caused a bunch of horrible new neuropathic issues but the pgad dropped to like a 1/10 it was great but my withdrawal was so severe I wound up in a psych hospital and they made me take Lexapro again. Within two days it came back but hit all branches of the nerve including penis and now with that branch I am at 10/10 mainly at night.

I caused myself so much withdrawal damage to get relief and now worse off!! and this is chemical nerve damage so I don’t think there is any chance of other treatments helping. My SI and functioning is horrible. I stopped the med a week after discharge but it has stayed although at least the burning stopped. Tried baby dose of mirtazapine for sleep for a few days and started getting arousal so strong my nasal passages swelled. I can only pray the nerve heals.

just trying to figure out if there's a correlation between when I take melatonin for sleeping and when my symptoms get worse. I'm not 100% convinced, but anything's possible. wondering if anyone else has noticed anything related to this with their own symptoms.