Vaginal tearing from sex

Yeast infections, STDs, and ingrown hairs: Our lady parts are no strangers to unwanted, uncomfortable issues. And they’re not immune to injuries, either—we’re talking bumps, bruises, scrapes, and tears. Here, five ways you can hurt your hoo-ha (and what to do if you find yourself in a precarious situation):

1. You Can Bruise Your Vagina

When Jules Wainstein of Real Housewives of New York climbed through a window and wound up with a vaginal hematoma, we thought, a vaginal what? It turns out a hematoma is just a bruise, says Fahimeh Sasan, doctor of osteopathic medicine, an assistant professor of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine at Mount Sinai. You might notice a bump, swelling, and black and blue—the result of blood collecting under the skin, she explains. But unless you’re straddling a windowsill a la Jules, such an injury is rare, since your lady parts are pretty well protected. “You’d really have to be doing something special to have this happen in everyday life,” says Sasan. A few real-life instances where it’s more common: intense mountain biking or childbirth, says Sasan. For the most part, though, the bruise will heal with a little bit of ice and time, she says.

2. You Can Fracture Your Pelvis

Breaking the bones in your pelvic area (right up next to your reproductive system) is pretty rare; they account for just about 3 percent of all fractures, according to the American Academy of Orthopedic Surgeons. But, hey, stuff happens. In fact, the American Association for the Surgery of Trauma estimates that about 8 to 9 percent of blunt trauma incidents—falls and car or bicycle accidents—result in injuries to the pelvis. The good news? Most pelvis fractures are minor—and while they hurt like heck, they usually don’t require surgery. Regardless, if you’ve been in an accident or are worried about a break, get an X-ray to find out.

RELATED: 5 Very Bad Things That Can Happen to Your Vagina in Old Age

3. You Can Cut Yourself

Most injuries below the belt are related to hair removal, says Sasan. And anyone who’s ever shaved or suffered through a bikini wax knows both can result in unintentional cuts. Ow. The main problem with nicks: They up your risk for issues like ingrown hairs, which can become inflamed and painful, says Sasan. Going bare below the belt could increase your chances of infection, too. One French study found a link between ladies who removed their down-there hair through waxing and shaving and Molluscum contagiosum, an infection that causes irritated bumps. Sound familiar? Give your skin a break by cutting back on your routine. And to rule out issues like genital herpes or warts, check in with your doc any time you notice a lesion or bump, says Sasan.

4. You Can Get Burned

A bad Brazilian is any girl’s worst nightmare—and for good reason. Too-hot wax can lead to serious irritation and even burns. A good technician will know the ideal temp for your wax (and use a thermometer to gauge it), but if it feels too hot, it likely is. Most reputable places keep wax to a steady warm temp, but if you get scalded, ask for a cold compress, which can relieve the redness and pain while you wait for the wax to cool. Waxing yourself? Make sure to test the temperature on your wrist first before applying anything to your bikini area.

RELATED: What to Do Before and After a Brazilian Wax So Your Skin Doesn’t Freak Out

5. You Can Tear Your Labia

If you’re too dry down there or had very rough sex, you could have a labia tear on your hands, says Sasan. How you can tell: If you bleed, feel uncomfortable peeing, and/or you’re in pain down there after you get your freak on, that could signal a tear. While this is rare—often, your natural lubrication (and lube!) is enough to keep things flowing down there without a tear—it happens. Also, tears tend to be a little more common if you’re using a sex toy or if it’s your first time doing the deed, says Sasan. If you think you may have a tear, see your doc. Often the treatment plan is just to let the area heal on its own, but sometimes you may need to be stitched up, says Sasan.

Cassie Shortsleeve Freelance Writer Cassie Shortsleeve is a skilled freelance writer and editor with almost a decade of experience reporting on all things health, fitness, and travel.

Of all the places to get a cut, this is probably last on your list. But vaginal tears are actually very common, and not just for people who’ve given birth. They can occur for a number of reasons, and are mostly nothing to worry about.

Shohreh Beski MD FRCOG, a consultant obstetrician and gynaecologist from The Regenerative Women’s Clinic explains, “The majority of vaginal tears are caused by trauma”, so the best thing you can do is work out what’s causing them and how best to manage the situation, including some pain relief. Because a happy vagina is a basic right.

What causes vaginal tears?

The big bad tears we hear about are usually associated with childbirth, but it’s common to get smaller, less visible tears on your vagina or vulva for a number of non-baby related reasons. Joy! Essentially, it comes down to lubrication – the holy grail of vaginal interaction. The skin around your vagina and inside your labia is sensitive and if you’re having sex or doing anything down there without sufficient lubrication the skin cannot move against friction and instead will be pulled until it tears. Like Dr Beski says, it’s all about avoiding trauma.

Similarly, inserting tampons if the vagina is too dry can cause micro-tears, as can masturbating without enough lubrication. Often, you’ll feel a sharp pain as these micro tears happen, but it is possible not to realise until after the fact, at which point you might find a small amount of blood, or notice pain next time you touch the area.

Sidenote: while not strictly your vagina or vulva, it’s also common to experience perineal tears from putting excess pressure on the perineum (the area between the vagina and anus). Having sex with a partner whose penis or toy is too big for you, not using enough lubricant or doing positions that put additional strain on the perenium (like having sex from behind), can all cause perrennial tears.

FotoMaximumGetty Images

How can you treat vaginal tears?

The vagina is a self-healing, self-cleaning, all round efficient body part and most micro-tears will heal themselves within a few days. But in the meantime – don’t push it: stop having sex for a few days to give the area a rest. Keep the area clean (warm water only please, remember how we said the vagina was self-cleaning?) and free of any perfumes, soaps or anything else that might exacerbate the wound.

Dr Beski advises: “Simple changes must be made; change your underwear. Don’t wear tights. Don’t wear polyester – cotton only. To begin with, you must change the conditions and ensure that you are not creating a sweaty or irritated environment.”

How can you prevent vaginal tears from happening?

I can’t stress it enough: lubrication, lubrication, lubrication. Put simply, whatever you’re doing the biggest risk of vaginal tears is from a lack of lubrication. It also puts you at pretty big risk of having rubbish sex… so lube up, whether you think you need to or not. Plus, give yourself the best chance of getting wet: when aroused, blood flows to the vagina causing it to swell and self-lubricate, so give yourself time to become properly aroused and for your body to respond, don’t rush straight into penetration. That’s a really good way to tear yourself a new one, literally.

Maryna TerletskaGetty Images

When should you see your GP for a vaginal tear?

Vaginal tears are totally normal and pretty common, and like we said, they tend to clear up on their own. But if you’re concerned, the general rule of thumb is – go to your doctor, that’s what they’re there for. According to Dr Beski, “If you have any concerns or prolonged itching or discomfort then you should see your GP. Certainly, if you notice persistent symptoms for more than 3 months then visit your GP.”

Above all, the main thing to remember is that if it’s happened to you it’s probably happened to someone else. We’re all just trying to understand our bodies, one confusing change at a time.

Shohreh Beski MD FRCOG is a consultant obstetrician and gynaecologist from The Regenerative Women’s Clinic.

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Patient Education

Vaginal Tear (Non-Obstetric)

A vaginal tear (laceration) is a wound in the tissues of the vagina. It can be caused by damage during sex. Putting a foreign object into the vagina may also cause a tear. Other factors that can make a tear more likely include thinning of tissue in the vagina due to aging or scarring of the tissue due to surgery. A straddle injury (injury in the crotch area during activities such as cycling) can also lead to a tear in the vagina.

Treatment depends on how severe your tear is:

  • Shallow (superficial) tears may cause mild pain and light bleeding. These tears often heal on their own with very little treatment.

  • Deep tears are more likely to cause more severe pain or heavy bleeding. They must be repaired with surgery.

Home care

  • To help relieve pain:

    • Use over-the-counter pain medicine as directed. If needed, stronger pain medicines may be prescribed.

    • Soak in a bath with a few inches of warm water. Do this for 10 to 15 minutes a few times a day, or as directed.

  • If you lost a lot of blood, you may feel weak. Rest as needed until you feel stronger.

  • Avoid touching the tear while it is healing.

  • Don’t douche unless your healthcare provider says it’s OK.

  • Wait to use tampons or have sex until the tear has healed. This may take a few weeks or longer.

  • If the tear was an accidental injury during sex, ask your provider how you might prevent similar injuries in the future. This may include using a water-based lubricant during sex.

Follow-up care

Follow up with your healthcare provider, or as directed. If stitches were used to repair your tear, these will dissolve on their own and don’t need to be removed.

When to seek medical advice

Call the healthcare provider right away if any of these occur:

  • Bleeding continues or worsens

  • Pain continues or worsens

  • Unusual or foul-smelling discharge from the vagina

  • Fever of 100.4ºF (38ºC) or higher, or as directed by your provider

  • Dizziness, weakness or fainting

PMC

Dear Editor

Rectovaginal tears occur after sex toys insertion, rape, and accidents1. They may cause severe life-threatening bleeding2. Rectovaginal tears after consensual sexual intercourse, are extremely rare3. In most cases, a sphincter trauma is present. We report a case with a two cm laceration to the posterior vaginal and anterior rectal wall, sparing the sphincters.

A 22-year-old nulliparous woman presented with acute vaginal bleeding and severe pain after sexual intercourse with her male partner. The couple reported no use of sex toys or foreign bodies during sexual intercourse. Vaginal examination revealed a two cm laceration of the vaginal wall, communicating directly with the anterior rectal wall. No injury of the anal sphincters was recognized. She was informed about her condition and the available treatment options. Under general anesthesia, she underwent an open diverting loop sigmoidostomy. No imaging was performed before operation as it was not considered necessary by surgeons. Continuous suture technique in two-layers (rectal – vaginal wall) was utilized for the repair of the vaginal tear with 1/0 Vicryl Rapide suture (Ethicon Inc., Somerville, NJ, USA). The operation lasted about 90 minutes. During her hospitalization she was administered intravenous Cefoxitime and Metronidazole for two days, and then per os for another 7 days. Her postoperative course was uneventful, and she was discharged the fourth postoperative day. Six weeks later, on her follow-up examination, the vaginal tear had completely healed and reversal of sigmoidostomy was performed at that time.

Sexual intercourse is the major cause of vaginal injury, apart from a vaginal delivery. According to literature risk factors for severe genital trauma, either after consensual or nonconsensual sexual intercourse, are the vaginal atrophy and anatomical changes due to menopause2,3. First sexual experience, nulliparity, rape, and young age are also risk factors for coital injuries during intercourse2. The mechanism is not fully known, but vigorous penetration and congenital weakness of the posterior vaginal wall have been regarding as possible reasons. During anal penetration, the posterior vaginal wall may be injured leading to rectovaginal tear. Simultaneous penetration to vagina and anus is another cause of high pressure to the posterior vaginal wall. Minimal vaginal bleeding very often leads to a delayed presentation and diagnosis while severe vaginal bleeding is reported to have led to hemorrhagic shock3. Prompt repair of the tear provides better healing and less postoperative complications4.

A high index of suspicion is required to define the possibility of nonconsensual intercourse, even if the patient denies it. Patients many times deny nonconsensual sex, because of its social impact. On the other hand, there are situations when they invoke false nonconsensual intercourse, to achieve money avail. So, this rare incident is a challenge for the attending physician due to its social and legal dimensions.

(Picture: Ella Byworth for Metro.co.uk)

The idea of your vagina tearing is pretty terrifying.

Most of us associate tears with ripped perineums thanks to the wonders of childbirth. Those are indeed bloody scary.

But tears don’t always happen on such a dramatic level. Along with large tears you can easily see (and feel. Ouch.), it’s also possible – and extremely common – to develop micro-tears in the vagina and vulva.

These are teeny-tiny tears that are usually caused by sex, inserting a tampon, or masturbation.

Micro-tears happen when the vagina is not properly lubricated, and the membrane or skin gets pulled. Because the skin around this area is delicate, the pulling on dry skin can cause tears – think of them in the same way as stretch marks: When skin is pulled and it’s too tight to move, it tears.

You may notice a vaginal micro-tear has happened as you’ll feel some pain as it’s created, and may spot a small amount of blood during sex.

(Picture: Ella Byworth/metro.co.uk)

You might also notice a micro-tear after the fact, as it can twinge a bit when touched. Having sex after you’ve developed a micro-tear can be sore and cause additional bleeding, as it’ll be re-opened by the same movement.

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The good news is that the vagina is smart enough to heal micro-tears itself, and won’t need any additional medical help unless it’s a serious tear that’s bleeding excessively or causing pain for longer than a few days. In most cases, a micro-tear will be all healed and free of any issues within three days. Easy.

The key thing is to allow the micro-tear to heal, otherwise it could continue to be opened up.

To do that, it’s best to either avoid sex immediately after you’ve noticed a micro-tear (it’ll likely be painful, anyway, so you won’t necessarily want to get saucy), or make sure you’re using plenty of lubrication. It’s also worth avoiding any scratchy lace underwear, and if you’re using tampons, go slowly and gently or swap to pads if it’s smarting.

Your best approach to micro-tears, however, is prevention.

(Picture: Ella Byworth for Metro.co.uk)

Micro-tears usually happen during sex when the vagina isn’t wet enough, which commonly happens when partners rush through foreplay and go straight to penetration.

You need to be properly aroused before penetration to make sex safe and enjoyable, as this allows the vagina to expand and self-lubricate, so it’s crucial to do all the pre-penetration bits that turn you on.

If you’re struggling with persistent vaginal dryness, don’t feel weird about using lube – everyone needs a little helping hand sometimes – but do make sure to chat with a gynaecologist or your GP to check it’s not being caused by another issue. Some medication can contribute to vaginal dryness, so it’s worth mentioning.

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Always ensure that sex goes at a pace you’re comfortable with and that if it hurts, you take a breather rather than pushing through it. Sex shouldn’t be painful (unless you want it to be) and you could cause further micro-tears by continuing when you’re not fully aroused.

Make sure you’re gentle when it comes to fingering, and keep nails fairly short and filed, so there are no jagged edges that can catch on your vagina.

If you do find yourself with a micro-tear, don’t panic. As we mentioned, they’re incredibly common and will look after themselves.

Just make sure that you go to a doctor if a vaginal tear isn’t so micro – if it’s bleeding, if it’s deep, or if it’s a posterior fourchette fissure (when the bottom of the vaginal entrance begins to tear), which has the potential to tear further and cause issues.

Other than that, go forth and have safe, pain-free sex. Enjoy.

MORE: A bump during sex could leave you with a bruised cervix

MORE: How sex changes when you have a stoma

MORE: Weird reasons you might be spotting or having a longer period than normal

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Recurrent fissuring of posterior fourchette

What is the posterior fourchette?

The posterior fourchette is a fork-shaped fold of skin at the bottom of the entrance to the vagina.

What is fissuring of the posterior fourchette?

The posterior fourchette is a thin tissue designed to stretch. However, it sometimes fails to stretch properly, and instead splits. This is a cause of recurrent vulval pain. Pain from fissuring is often described as being ‘like a paper-cut’ or ‘knife-like’.

Recurrent fissuring has been previously called vulval or vulvar granuloma fissuratum.

What symptoms arise from posterior fourchette fissures?

Most women that present with posterior fourchette fissures are sexually active and symptoms follow intercourse. Symptoms may be mild, moderate or severe in intensity, and usually resolve within a few days.

  • Pain on vaginal penetration during intercourse (dyspareunia)
  • Pain on insertion of a vaginal tampon
  • Pain during vaginal examination
  • Tearing sensation
  • Bleeding or spotting
  • Itching
  • Burning
  • Stinging on contact with semen, water or urine

Affected women may be premenopausal or postmenopausal. Fissuring can occur at the first attempt at sexual intercourse or many years later, in women who have had children or who have never had children. They may also have other symptoms, including fissures in the skin folds elsewhere in the vulva.

What is seen on examination?

On careful clinical examination, there is usually a tiny split or linear erosion at the midline of the base of the vagina on the perineal skin. Colposcopy (magnification with a bright light) may be necessary to see the fissure. The posterior fourchette may form a tight band or tent (membranous hypertrophy). In some cases, signs may be more impressive and include:

  • marked tenderness
  • deep, wide ulceration
  • redness of surrounding tissue
  • swelling or lumps
  • scarring.

The vulva may appear entirely normal if the examination takes place after the fissure has healed. But often, a new fissure can be observed to appear while gently stretching the vulva.

What causes fissuring of the posterior fourchette?

The splitting occurs when the vulva stretches, particularly during sexual intercourse. This may be because the skin is stiff, inflamed, fragile, or for unknown reasons.

Posterior fourchette fissuring may be primary, i.e., no underlying skin disease is diagnosed, or secondary to an infection or inflammatory skin disease. Common causes include:

  • vulvovaginitis due to Candida albicans (thrush)
  • herpes simplex infection (genital herpes)
  • atrophic vulvovaginitis
  • contact dermatitis due to irritants or less often, allergy
  • seborrhoeic dermatitis
  • atopic dermatitis
  • lichen simplex
  • aphthous ulceration
  • lichen sclerosus
  • delayed healing of tear or episiotomy wound following childbirth
  • pelvic floor muscle tension leading to vaginismus

Laceration of the posterior fourchette may also be due to straddle injury, violence or rape but in these situations bruising and other injuries are likely to be present.

Similar symptoms experienced in the absence of fissuring or other visible signs may be described as vulvodynia or vestibulodynia.

What investigations should be done?

Specific tests are often unnecessary if the history and appearance are typical.

Swabs may be taken to look for vaginal infections such as bacterial vaginosis and Candida albicans, for sexually transmitted infections or herpes virus.

Biopsy may show typical features of the underlying skin disorder. The histopathology of primary fissuring usually reveals nonspecific submucosal chronic inflammation; the clinician may consider the report nondiagnostic. Granuloma formation is rare. Scar tissue may be present.

What is the treatment for fissuring of the posterior fourchette?

If an underlying infection or skin condition is diagnosed, specific treatment is usually very helpful. Examples include:

  • antifungal creams or antifungal tablets for thrush
  • Antivirals such as aciclovir, famciclovir or valaciclovir for genital herpes
  • intravaginal oestrogen cream for hormone deficiency states during menopause or lactation
  • topical steroids for dermatitis or lichenoid disorders.

Women with mild symptoms due to primary fissuring of the posterior fourchette may benefit from:

  • explanation
  • avoidance of irritants such as soap, spermicide cream, irritating lubricants or rough panty liners
  • application of vaginal moisturisers and bland emollients such as petroleum jelly
  • warm Sitz baths with bath oil
  • non-soap cleansers
  • liberal lubrication with oil during sexual activity (water-based lubricant should be used with condoms as oils may cause these to disintegrate)
  • topical anaesthetic application (lignocaine jelly or ointment)
  • woman-on-top or man-behind positioning
  • vaginal dilators
  • pelvic floor relaxation exercises.

Perineoplasty

Women with severe symptoms from primary fissuring of the posterior fourchette may consider vulval surgery. Perineoplasty is a surgical procedure that is usually undertaken under general anaesthesia. The fissured skin is completely cut out and replaced by vaginal epithelium that has been undermined then advanced to cover the defect without tension. It is stitched up from front to back. Perineoplasty may allow women with posterior fourchette fissuring to resume normal and painless sexual activity but is not always successful.

So, you and your partner just got done with your bedroom marathon and the pain is finally settling in. But before you freak out over burning urination, you may be experiencing something far less serious than an STI or a medical condition. Although pain during or after sex can be attributed to more serious health issues, it’s likely that you simply received some cuts while getting it on. “Yes — it’s actually quite common to get small tears on the vaginal walls during sex,” One Medical provider Navya Mysore, MD, told POPSUGAR.

Oftentimes, this occurs when the vaginal area isn’t sufficiently lubricated. Dr. Mysore added that other conditions, including lichen sclerosis, eczema, psoriasis, or lichen planus, can make getting vaginal tears more common. So, how do you differentiate pain caused by an STI vs. a vaginal tear? You may see a small amount of spotting or feel minor irritation or burning with urination, but other symptoms can indicate a potential infection: different colored discharge, itchiness, pus from the site of the tear, vaginal lesions, or pelvic cramps or pain. If you experience any of these symptoms, you should see your primary care provider.

How to Treat Vaginal Tears Caused by Sex

“Most often, small vaginal tears will heal on their own,” Dr. Mysore said. “Vaginal mucosa is very well innervated with blood flow and tends to heal very quickly.” She also advises you clean superficial cuts with warm water once or twice a day and avoid using harsh or scented soaps on the area. I’ve personally found coconut oil to be a miracle worker when it comes to soothing and healing painful cuts caused by too much friction during sex. Just apply a small amount onto the skin surrounding the vaginal opening and on the inner labia for instant relief.

If the pain is significant, Dr. Mysore recommended taking over-the-counter pain relievers such as ibuprofen or acetaminophen. In the meantime, it’s best to wear cotton underwear and to avoid wearing tight clothing. You also may want to give sex a break for a day or two until the pain subsides.

How to Prevent Them From Happening

Lubrication is key! Make sure you’re fully aroused before penetration and go slowly at the start. “Make sure fingers are clean and fingernails are trimmed, so there are no inadvertent cuts with possible foreplay,” she said.

Image Source: Pexels / Pete Johnson

It’s Not Just Childbirth That Can Give You a Vaginal Tear

Women’s vaginal tissues sometimes tear.

There, we said it. Even though no one really wants to talk about it, we’re going to because you might want to know what to do if it happens. And how to lessen the odds that it will.

You might tear giving birth and at other times, too

Tears are common in women having their first vaginal birth. These obstetric tears are almost always tears of the perineum (the area between the vagina and rectum) that occur when pushing a baby out.

Besides obstetric tears, other vaginal or labial tears are uncommon (phew). When they do occur, they can result from friction against a saddle or a hard landing on your bicycle frame (or anything narrow and unforgiving).

You may also experience vaginal irritation and microscopic tears from soap that doesn’t get rinsed off, a too-big tampon whose dry end rubs against you, a razor that overshoots the landing strip, or a waxing nightmare (please no).

Even your favorite pair of skinny jeans could be the culprit if worn commando.

But the most common cause of non-obstetrical vaginal tearing is sex, says Anna Shope, M.D., an obstetrician gynecologist who sees patients at the UW Neighborhood Shoreline Clinic and UW Medical Center-Roosevelt.

Why sex can cause vaginal tears

There is a series of small marvels your body performs to prepare for an intimate visitor—the warm-up known as arousal. Your vaginal tissues engorge, swelling your labia and clitoris, and producing that hostess with the moistness—vaginal lube.

This vaginal fluid protects your delicate skin down under by reducing friction and irritation.

“It’s like preheating the oven. You don’t just stick the casserole in,” says Shope.

But there are many variables that can affect just how much lube your body produces. And without enough lube, you’re more likely to tear.

Estrogen is a hormone important to the lube-making process. Its levels vary according to where you are in your menstrual cycle, peaking around ovulation and dropping low just before your period.

If you are breastfeeding or menopausal, your estrogen levels are likely to be lower, too. A curveball like emotional stress can also reduce lube production. So can alcohol, cigarettes, antihistamines, cold medicine and prescription medications, including birth control pills and antidepressants.

“Even young women who are perfectly healthy often need more lubrication than what they produce themselves,” says Shope. “Vaginal penetration without enough lubrication is not only less comfortable and less pleasurable, but it increases the chance of tearing.”

How to prevent a tear down there during penetration

Here are five strategies that help lessen the likelihood of a tear during sexual penetration.

Be in the mood. Arousal creates the engorgement and lubrication you need to make penetration both more pleasurable and more comfortable, says Shope. So be sure you’re turned on before sexual penetration.

Engage in plenty of foreplay. Women should not be shy about needing a lot of foreplay. Give your body time to prepare by letting anticipation build.

Use lots of lube. Start using lube during foreplay, and be liberal about it. It’s always better to err on the side of too much lube, says Shope. And if you need to reapply lube while having sex it doesn’t mean you’re queen of the desert. It’s perfectly normal.

Go slow and keep it wet. If you go slowly and use plenty of lube, your tunnel of pleasure should be perfectly passable, even with a toy or partner on the larger side.

Control the degree and pace. When you’re ready for penetration, start with positions where you can control the degree and pacing. Use the same game plan when playing with sex toys.

“Remember that sex should never hurt,” says Shope.

If you do get a tear down there

When accompanied by pain and bleeding, a tear merits a visit to your OB-GYN or primary care doctor, or the emergency room if it’s severe.

Sometimes you may not recognize a tear until you feel a burning or stinging sensation when you pee. If you’re unsure of the cause of a vaginal tear or irritation, you should get it checked out by your doctor just in case it’s a sexually transmitted infection, or something else.

But if you know the cause of the tear, and believe it to be superficial, then a trip to your doctor is not necessary unless the wound begins to show signs of infection.

Care for it as you would any other owie but with a little extra tenderness.

“The good news is that there is so much blood flow through the vagina and vulva that all parts of that area heal really well,” says Shope. For tears that don’t require a visit to the doctor, once you no longer have discomfort, you should be good to go.

How to Avoid Vaginal Cuts

Vaginal cuts and tears are a common problem in women who are sexually active. Although usually not serious, vaginal cuts can be uncomfortable and irksome. The good news, however, is that vaginal cuts can be prevented.

“Many women notice vaginal cuts and tears after sexual intercourse, and most of the time these tears and abrasions are normal,” says Edwin Huang, MD, a gynecologist at Massachusetts General Hospital in Boston. Vaginal cuts become more noticeable during sex, he says, because semen can sting when it comes in contact with the open cuts.

Even though minor vaginal cuts may not create long-term health issues,, they can negatively affect your experience of sex, and make you uncomfortable. A better course is to learn how to prevent the cuts from occurring in the first place.

Common Causes of Vaginal Dryness and Cuts

So what does cause vaginal cuts? When sexually excited, a woman’s vagina naturally produces fluids that lubricate the area during sexual activity, reducing friction that can irritate or tear the vaginal skin. If the vagina is not sufficiently lubricated, vaginal dryness can result. Dr. Huang says that vaginal dryness is a common cause of vaginal cuts. Other factors that play a role in vaginal dryness include:

  • Menopause. Women of childbearing age have higher levels of vaginal moisture, even when they are not sexually aroused, than menopausal women. During menopause, the level of estrogen, the female sex hormone, starts to decline. Huang explains that less hormonal stimulation sometimes leads to vaginal dryness.
  • Not enough foreplay. Sexual excitement causes the secretion of vaginal fluids, and an inadequate amount of foreplay before intercourse can lead to vaginal dryness, Huang says. Simply put, if you’re not sufficiently excited before you have penetrative sex, your vagina will be drier than it should be for maximum comfort, and vaginal cuts and tears are more likely to occur.
  • History of abuse. Although this is not the most common cause of vaginal dryness, a history of sexual abuse can affect a woman’s relationship to sex. Huang says that survivors of abuse may have a hard time relaxing during sex. Or they may be uncomfortable with foreplay, making it hard for them to become aroused. Sexual arousal causes the vagina to produce additional fluids. If you cannot become aroused, your body will not produce vaginal fluids, leaving you more at risk for vaginal damage.
  • Other causes of vaginal cuts. According to Huang, some sexual positions tend to cause more vaginal tears and abrasions than others, and use of sex toys can also be a factor. Sex toys are sometimes made of materials that are irritating to the skin, or they might have sharp or rough edges.

Prevention of Vaginal Cuts

How can vaginal cuts be prevented? Since vaginal dryness is often responsible, increasing wetness in the vagina during sexual activity is often the best way to prevent vaginal cuts. Ways to do this include:

  • Lubricants. Commercial water-based lubricants can help with vaginal dryness. “Always use water-based lubricants,” Huang says. “K-Y Jelly and Astroglide are popular water-based brands.” What’s wrong with oil-based lubes? Products such as petroleum jelly, mineral oils, and massage oils — all oil-based lubricants — damage condoms, which puts you at higher risk for sexually transmitted diseases and pregnancy. Additionally, Huang says, many women are allergic to oil-based lubricants and find them irritating to the skin.
  • More foreplay. Huang recommends more foreplay and vaginal stimulation before intercourse as a good way to keep vaginal cuts at bay. Increased foreplay gives the vagina the time (and motivation) to naturally lubricate itself.
  • Sexual positions. For heterosexual couples, some positions are better than others. “With the woman on top, there’s less risk for vaginal cuts because she has more control,” Huang says.

With just a few precautions and some knowledge, vaginal cuts can be avoided, and your sexual experience will be more pleasurable and comfortable.

(Picture: Ella Byworth for Metro.co.uk)

If you haven’t noticed, we’ve recently been covering all the injuries that can occur during sex, because safe sex is about more than just using a condom (but please do use a condom).

We’ve gone through semen allergies, vaginal microtears, and cervical bruising.

Now it’s time to chat about perineal tears.

Perineal tears tend to be associated with giving birth, but they can occur as a result of sexual intercourse, too.

Perineal tears are when the skin separating the vagina and the anus, called the perineum, is pulled apart and lacerates. They usually occur as part of childbirth, which makes sense, as pushing a baby’s head out of your vagina does tend to put a strain on things.

But as we mentioned, perineal tears can happen during sexual intercourse, often as a result of rough penetrative sex without proper lubrication.

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Tears can occur to different degrees, including a third degree laceration, which is a tear only on the skin, or a fourth degree laceration, which occurs when the tear makes it way through the anal sphincter. A fourth degree laceration is a lot more serious as this can cause infection and issues with defecating, but it’s also much more rare.

The majority of tears that occur during sex are very small third degree lacerations.

(Picture: Ella Byworth for Metro.co.uk)

Some things that could cause a small perineal tear include a partner’s penis being too large for your vagina, a lack of lubrication, rough and intense sex, or a position that puts strain on the perineum.

You’ll know if a tear has occurred as the area will be sore and painful to touch. There may be some bleeding.

It might not be immediately obvious that you have a perineal tear until you try to have sex again, when you’ll experience pain.

The best way to treat a small perineal tear is to abstain from penetrative sex until it’s healed (more sex will pull apart the delicate skin, causing it to tear further). If it’s not healing, it’s bleeding, or it’s extremely painful, it’s important to talk to your GP, as a larger tear may require stitches for repair.

If you find yourself frequently getting perineal tears, you’ll need to see your GP, regardless of how big the tears may be. There may be an underlying medical cause, such as yeast infections, dermatitis, problems with your pelvic floor muscles, or allergies, and it’s best to figure that out sooner rather than later.

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But as with most things, prevention’s the best fix.

Make sure that you’re always properly lubricated and fully aroused before any penetrative sex. Dry tissue is more likely to tear.

If there’s any pain or soreness, stop – sex shouldn’t be painful unless you want it to be.

If you can feel certain positions straining on your perineal area, try swapping around, and make sure your partner isn’t going too hard and rough on the penetration. Many of those who’ve experienced perineal tears report their partners resting the penis on the back wall of the vagina, causing strain and longterm pain. Woman-on-top can work better, as well as doggy style.

And remember that if you do experience a tear – no matter how big or small – don’t ignore it. Trying to push through and keep having sex will only make things worse. You need to be entirely healed before you should even think of putting anything in your vagina again.

Stay safe out there.

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Re-stitching broken down perineal (the area between the vagina and back passage) wounds compared with non-stitching

It is estimated that 350,000 women per year in the United Kingdom and millions more worldwide experience perineal stitches because of a childbirth-related natural tear or cut (episiotomy). Sometimes the perineal wound breaks down (opens up). This may be because it becomes infected, which could lead to systemic infection and sepsis. The current management of broken down wounds varies widely between individual health practitioners and hospitals. For most women the broken down perineal wound is left to heal naturally (managed expectantly). This is a slow process and it can take several weeks for the wound to heal completely resulting in persistent pain and discomfort at the perineal wound site, also possible urinary retention and defecation problems. The alternative is re-stitching. Due to the lack of research evidence, we do not know the best way to treat this type of complication. This review looked at randomised controlled trials of re-stitching broken down wounds compared with non-stitching. Two small studies were identified. One study, involving 17 women, showed a marginal tendency to improved healing in the women who were re-stitched, however, this evidence was not conclusive. In the other study involving 35 women, more women had resumed intercourse in the re-suturing group at two months. As the studies were small and of poor quality, it is not possible to draw conclusions about the best way to manage wound breakdown after childbirth. Therefore, there is an urgent need to conduct further studies to compare fully the benefits and risks of both treatments.

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