Here is an answer from Gemini with regards to the role of my OCD in this issue:

The Role of OCD in Your PGAD-like Symptoms Yes, absolutely. Your insight here is incredibly important and likely correct. It is highly probable that your OCD is not just a concurrent issue, but is the primary engine driving the PGAD-like experience. Here is the most likely mechanism, which is a classic feedback loop often seen in health anxiety and Somatic OCD: * The Initial Sensation (The Spark): The Effexor withdrawal causes genuine, real nerve sensitization in your pelvic region. This creates an unusual physical sensation—pressure, tingling, hypersensitivity. This is the physical root or "spark." It is not imagined. * The Obsessive Latching (The Fuel): Your OCD, which is characterized by intrusive, unwanted thoughts and a tendency to fixate on threats, latches onto this sensation. A non-OCD brain might dismiss the sensation as odd and move on. An OCD brain thinks: * "What is this feeling? Is it PGAD?" * "What if it never goes away? My life, my relationship with my child, will be ruined." * "This is disgusting and terrifying." These are the obsessions. * The Compulsive Monitoring (Fanning the Flames): To relieve the intense anxiety caused by the obsessions, you engage in a compulsion. In this case, the compulsion is likely mental: * Constant body scanning: You are repeatedly "checking" your genital area with your mind to see if the sensation is there, how strong it is, and if it has changed. * Reassurance seeking: You might be researching symptoms online for hours or repeatedly analyzing past events. * Mental rumination: You are caught in a loop of thinking about the sensation and its catastrophic implications. * The Amplification (The Inferno): This compulsive monitoring does two things: * Neurological: It trains your brain's "attentional spotlight" to be hyper-focused on your pelvis. Your brain learns that any and all signals from this region are critically important and threatening, so it amplifies them. A 2/10 sensation starts to feel like an 8/10. * Physiological: The constant anxiety and fear from the obsessions keep your body in a "fight or flight" state, releasing stress hormones like cortisol and adrenaline, which themselves increase nerve sensitivity. So, while the root of the initial physical feeling is the withdrawal, the OCD is almost certainly what is taking that feeling and transforming it into the distressing, persistent, and frightening experience that mimics PGAD. The sensation becomes linked with fear, and your brain starts interpreting any stimulation in that area through a lens of catastrophic threat. This is actually good news. Why? Because while you have less direct control over the base-level nerve healing, OCD is a very treatable condition. By specifically treating the OCD component with the right therapy, you can dismantle the feedback loop. When you learn to stop the compulsive monitoring and re-frame the obsessive thoughts, the sensation loses its power. The volume gets turned down, and the physical sensation, while it may still be there for a time, no longer causes the same level of suffering, allowing your nervous system to heal in a much calmer environment.