Perineal Pain
Perineal pain treatment includes rest, antibiotics, and massages.

The perineum is the region between the thighs that includes the space between the genitals and anus. The most common treatment for perineal pain is rest; rest helps the body repair the damage. A few antibiotics and massages are used to treat perineal pain but are done only once the inflammation subsides.

  • The perineum is the major area of muscle attachment, making it the most common area of pain.
  • Perineal pain can affect both men and women.
  • It is the space between the scrotum and the anus in men and the vaginal opening and the anus in women.

How is perineal pain treated?

Perineal pain treatment may vary depending on the underlying condition. Sometimes, the treatment varies in men and women:

  • Get adequate rest.
  • In cases of perineal pain caused by perineum tear or episiotomy, regular sitz baths, numbing spray, and pain reliever drugs may provide temporary relief. 
  • Antibiotics can help treat certain types of perineal pain.
  • Pelvic floor massage therapy helps manage long-term pain.

How is perineal pain diagnosed?

Perineal pain includes a physical and medical examination. The doctor may recommend special tests depending on the underlying cause of the condition.

Common diagnostic tests include:

  • Blood tests
  • Urine analysis
  • Radiological evaluation or ultrasound

What are the signs and symptoms of perineal pain?

Most men and women who experience perineal pain display symptoms, such as:

Additional symptoms in women

Additional symptoms in men

SLIDESHOW

Pain Management: Surprising Causes of Pain See Slideshow

What are the causes of perineal pain?

The causes of perineum pain differ in men and women, but a few causes remain the same in both genders.

Tears during childbirth

Most women experience perineal tears during the delivery of the first child. A few women may get severe tears, which may extend to the vagina.

These perineal tears are very painful that may cause severe discomfort while performing regular activities, such as walking and sitting.

Regular sitz baths with anesthetic sprays and cold packs may help relieve pain. If a woman develops a fever, severe pain, a foul odor, or any fluid discharge from the tear, they should immediately consult their doctor and seek medical attention. They should use pelvic floor massage therapy to avoid chronic pain after the tear heals.

Episiotomy

An episiotomy is a common procedure where doctors make an incision or cut to extend the vaginal opening during childbirth. Episiotomy pain is almost similar to the pain during perineum tear. In a few cases, the episiotomy may cause injury to adjacent areas, possibly leading to surgery. Due to this, a few experts are recommending avoiding routine episiotomies.

Regular sitz baths, numbing spray, and pain reliever drugs may provide relief from the pain for a short duration. Pelvic floor massage therapy helps manage long-term pain.

Other perineal injuries

Both men and women experience perineal injuries. Trauma caused by a fall or an assault can damage the muscles of the perineum, causing severe pain. Medical conditions, such as diabetes, can damage the nerve, resulting in severe pain.

Pelvic floor dysfunction

Pelvic floor muscles provide support to pelvic organs, such as the urinary bladder. Pelvic pain can affect both men and women. However, it is most common in women after giving birth. In pelvic floor dysfunction, the muscles become stiff, causing muscle tension and pain. In women, urinary incontinence (a sudden urge to urinate and involuntarily passing urine) results from muscle weakness.

Pelvic floor exercises and massages can help treat pelvic floor dysfunction.

Hemorrhoids

Hemorrhoids are swollen blood vessels in the anus that causes bleeding during bowel movements. Some hemorrhoids cause pain in the perineum due to increased pressure.

Regular sitz baths after each bowel movement and using hemorrhoid cream provide some pain relief. Drinking plenty of water and having a high-fiber diet may relieve constipation.

Prostatitis

Prostatitis is an inflammation of the prostate that results in pain in the perineum. This inflammation occurs suddenly due to infection or injury and could cause long-term pain. In cases of infections, antibiotics are used to treat the condition. If the person experiences pain while urination or having sex, they should immediately consult a doctor.

Infections

Any abscess or cyst in the anal region or perineum may cause perineal pain. This area becomes swollen, red, and painful.

Numbing sprays, pain relievers, and antibiotics may help treat the infections.

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Medically Reviewed on 10/19/2022
References
Image Source: iStock image

Perineal Pain. https://www.ics.org/committees/standardisation/terminologydiscussions/perinealpain

Episiotomy – aftercare. https://medlineplus.gov/ency/patientinstructions/000483.htm

Vaginal tears in childbirth. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/multimedia/vaginal-tears/sls-20077129