How to relieve pain and burning from perineal tears?

Question

Hello doctor,

I have a tear near my vaginal area. One is severe, but the other is nearer the anus. It burns when I urinate and during sexual activity. I was spotting yesterday, and my boyfriend noticed it then and again tonight. I am very sore and have been nauseous.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

It sounds like you are going through quite a bit of discomfort right now. From what you have described, painful tears near the vaginal and anal area, burning while urinating, soreness during intercourse, spotting, and now nausea, this could be due to trauma or irritation from recent sexual activity. Given your age and symptoms, it needs to be checked properly to avoid complications.

The probable causes are as follows:

This could possibly be a friction-related vaginal or perineal tear, potentially worsened by rough intercourse or lack of lubrication. Infection is also a possibility, especially with burning, soreness, and spotting.

Investigations to be done are as follows:

A pelvic examination (in-person) by a gynecologist.
Urine routine and culture.
Vaginal swab for infection (candida, bacterial vaginosis, or STDs).
STI (sexually transmitted infections) panel, including chlamydia, gonorrhea, if there is a risk.

Differential diagnoses are as follows:

Vaginal yeast or bacterial infection.
Sexually transmitted infection (such as chlamydia or herpes).
Urinary tract infection.
Vaginal ulcer or fissure.
Minor internal trauma or abrasion.

Probable diagnosis is perineal tear with possible secondary infection.

The treatment plan is as follows: until you are seen by a doctor:

Avoid sexual activity to prevent further injury.

Keep the area clean and dry.
After urinating, wash gently with warm water.
Sitz baths (warm water soak) twice daily can help with healing.
If pain is severe, a mild over-the-counter analgesic such as Paracetamol can be taken.
Do not apply any creams without knowing what exactly caused it.

However, you need to be examined, as internal tears or infections can worsen quickly if ignored. If there is fever, foul-smelling discharge, or heavy bleeding, please do not wait; visit the emergency room.

Preventive measures are as follows:

Use adequate lubrication during intercourse.
Go slow and gently, especially if there is pain.
Use protection to avoid infections.
Keep the genital area clean and dry.

Regarding follow-up, I strongly suggest you get a local pelvic exam done by a gynecologist as soon as possible. Please update me once you get your urine test or if symptoms worsen, especially spotting or nausea. We can guide better with that.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.