Perineum is the area of between the anus and the genitals. In males, the perineum sits behind the scrotum and it is extended to the anus. However in a female perineum begins at the front of her vulva and is extended to the anus. Pain in the perineum affect both the gender but is common in female as she receives more injury during sex and during and after childbirth. The pain in the perineum is likely to last longer after the vaginal delivery of the first child. Our article today discuss the possible causes of pain in the perineum and treatment option.

How To Reduce Pain In The Perineum

What causes pain in perineum in females?

In females the pain in perineum may be caused due to following reasons:

Tear during delivery – 

Females who give vaginal birth suffer from some degree of trauma to the perineum. Some females experience severe pain if the tearing extends beyond the vagina even deep into the anus. These tears can be painful and makes it difficult for a female to use restroom, walk or performed daily functions or during the sex. More is the tearmore is the muscle problem and can be very painful affecting the functions of urinary bladder and anal sphincter. The pain in perineum following childbirth may last for several weeks. In most of the cases, the pain is relieved by taking painkillers prescribed by your doctor, applying cold pack and regular sitz bath. To manage chronic pain, females are recommended to practice pelvic floor physical therapy after the tear heals. If you see a sign of infection and experience severe pain, fever, bad smell coming from the tear or oozing from the tear it is better to consult a doctor. 

Episiotomy – 

The doctor makes a small cut in the perineum in order to expand the vaginal opening during vaginal delivery in this procedure.  However many experts are against the use of routine episiotomy still it is common procedure during childbirth. Episiotomy may increases the risk of incontinence and pelvic pain. The perineum pain is similar to that of the perineal tear.

Episiotomy

The healing time and the severity of the symptoms differ from women to women. To relieve the pain over the counter pain relievers are given for short-term relief. Pelvic floor physical therapy is useful to manage long-term pain. In some cases where episiotomy has caused injury to the surrounding areas surgery may be required.

 Pelvic floor dysfunction –

Pelvic floor muscles supports the pelvic organs. When the pelvic floor muscles become too tight and causes tension and pain it is termed as pelvic floor dysfunction. Alternativelyin some cases muscles become too weak resulting into incontinence. Pelvic floor dysfunction may affect the patient’s ability to pass faeces. Although any one can suffer from pelvic floor dysfunction, it is more common during and after pregnancy and delivery. Many females with pelvic floor dysfunction also experiences pain in the perineum. Depending upon the type of dysfunction the treatment is planned. The patient needs to work along with the physical therapist and doctorsto learn effective pelvic floor exercises.

 Perineal injuries – 

It includes perineal injuries other than perineal tear during or after delivery or episiotomy. Both male and female can damage the skin or the muscle of perineum if they are suffering from health conditions such as diabetes that causes damage to the nerve in the perineum. The treatment depends upon the injury and severity of pain. To improve cuts and scratches sitz bath is useful.

Perineal injuries

Referred pain –

In some cases such as colitis, appendicitis and other gastrointestinal conditions the pain begins somewhere else in the body and regulates to perineum. In such cases, the underlying cause is treated to relieve pain in the perineum.

Pudendal nerve Entrapment – 

Pudendal nerve is a nerve in the pelvic. Due to injury it may get entrapped or inflamed and causes pain that may extend to perineum. Pudendal nerve entrapment pain may gradually developed over weeks or may appear suddenly. To provide temporary relief pain relievers are given and gentle massage at the affected area is recommended.  However, the best is to see the doctor as soon as possible.

Pudendal nerve Entrapment

If pain in perineum is intense making routine activities difficult it is better to see your doctor and get it treated to avoid long term damage.

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