Pain in the perineum in women is provoked by gynecological diseases, traumatic injuries, proctological and urological pathologies. It is observed in varicose veins of the pelvic veins, is detected in chronic pelvic pain syndrome. Occurs during pregnancy. It happens short-term, long-term, spilled, localized, weak, strong, pulling, aching, cutting, burning. Often increases with a certain position of the body. The cause is determined by the results of the survey, gynecological and proctological examination, imaging and laboratory studies. Treatment includes antibiotics, hormones, NSAIDs, physiotherapy, surgery.
The perineum is the area between the external genitalia and the anus. Due to the proximity of the vulva, vagina and rectum, pain in this area in women most often occurs with gynecological and proctological diseases. In this place, the muscles of the pelvic floor are attached, which leads to the frequent occurrence of reflected pain when the internal organs and structures of the small pelvis are affected.
Normally, minor pain in the perineum in some women occurs during the period of ovulation. They persist for 2-3 days, pass on their own. Other causes of pain in this anatomical area are rubbing with rough or uncomfortable underwear, hard sex, or intercourse in an unphysiological position with excessive pressure on the back of the vulva and vagina. The symptom disappears after a few hours or 1-2 days, is not accompanied by other pathological manifestations.
Soreness in the perineum in women is provoked by the following pathologies of the external and internal genital organs:
Sometimes pain in the lower abdomen radiates to the perineum with endometritis, adnexitis and salpingitis. Radiating pain in the perineum can also occur with adhesive processes, ovarian cysts, benign and malignant tumors of the genital organs.
In adult women, perineal tears are most often observed during childbirth. Initially, pressing painful sensations appear, which, if the integrity of the tissues is violated, are replaced by sharp acute pain and bleeding. Perhaps a combination with ruptures of the vagina, damage to the anal sphincter and rectum. In some cases, perineal injuries are caused by rape, a blow to this area, or injury with a sharp object during a criminal incident.
Injuries of the genital organs in girls of preschool age, as a rule, occur in everyday life. Schoolgirls are dominated by street and sports injuries. The anamnesis reveals a fall on a blunt or sharp object, less often thermal and chemical burns are detected. Children complain of severe pain in the perineum and vulva. Possible external bleeding or hematoma formation. Of particular danger are internal bleeding, accompanied by increasing weakness, pallor and a drop in blood pressure.
The cause of severe injuries is sexual activity, in which extensive damage, intense pain, massive blood loss, and psychological shock are determined. In adolescent girls, ruptures of the perineum and vagina during childbirth are detected more often than in adult women in labor.
Perhaps explicit images of the genitals are hidden here Are you 18 years old? yes no Pain in the perineum in women
Pain in the perineum during gestation is usually noted after 35 weeks. At this time, the fetus in 20% of cases descends and presses its head against the exit from the small pelvis. Painful sensations are not intense, stabbing, due to pressure on soft tissues. The occurrence of pain at an earlier date may indicate a threat of miscarriage.
In the postpartum period, soreness in the perineal area is observed in almost all women. With uncomplicated childbirth and the absence of injuries, the symptom is provoked by edema and excessive stretching of the tissues, quickly decreases and disappears within a few days. In the presence of ruptures, suturing, the pain is more intense, acute in the first days, then - sore, aching. Disappear after 2 or more weeks.
Proctalgia is a sharp stabbing pain in the rectum, often radiating to the perineum, coccyx, anus and hip joints. It is not associated with the act of defecation, it develops against the background of neurogenic muscle spasm. It persists for several minutes or hours. It is provoked by excessive physical activity, severe psycho-emotional experiences, stressful conditions. It accompanies many diseases of the anus and rectum. In addition, pain in the perineum can be observed with the following diseases:
Women with perineal and vulvar VRVMT complain of dull arching pains, heaviness and itching in the perineum and vulva. During an external examination, visually noticeable varicose vessels are detected, sometimes swelling of the labia. With the development of thrombophlebitis, pain becomes acute, intense, accompanied by severe edema, hyperemia, and general hyperthermia. Palpation determined dense painful veins.
With the syndrome of venous plethora, the epicenter of pain is located in the lower abdomen. Aching pains radiating to the perineum, groin, sacrum or lower back. The symptom intensifies in the second half of the menstrual cycle, with a long stay in a standing or sitting position, sexual intercourse, physical activity. Dyspareunia, algomenorrhea, dysuria are often observed.
It is a polyetiological condition, found in many gynecological and urological pathologies, lesions of the osteoarticular apparatus, retroperitoneal tumors, diseases of the gastrointestinal tract and peripheral nervous system. CPPS in women is manifested by dull aching pains in the perineum, lower abdomen, groin, pubis, sacrum and coccyx. Pain is aggravated by hypothermia, defecation, urination, physical activity, prolonged sitting or standing.
It is an elastic protrusion in the area of the perineum, labia majora or near the anus. At the initial stages of the development of a perineal hernia, patients are periodically disturbed by pulling pains in the perineum or lower abdomen. Subsequently, the pain syndrome becomes constant, gives to the thigh and lower back. Pain is aggravated during sexual intercourse. Dysuric disorders are possible due to the ingress of the bladder into the hernial sac.
Sometimes pain in the perineum is observed when the following body systems are affected:
Establishing the etiology of pain is the responsibility of gynecologists. During the survey, the specialist finds out the circumstances of the symptom, the dynamics of its development over time, the relationship with various factors (posture, sexual contacts, natural functions, the phase of the menstrual cycle), the presence of other manifestations. As part of a diagnostic search, procedures such as:
In addition, X-ray techniques, computed tomography and magnetic resonance imaging can be used to clarify the diagnosis. If there are indications, a proctologist, urologist, orthopedic traumatologist and other specialists are involved in the examination.
Perhaps explicit images of the genitals are hidden here Are you 18 years old? yes no Perineal tear closure
The list of therapeutic measures is compiled taking into account the cause of pain in the perineum:
With pain in the perineal zone, the following operations can be performed: