Perineum Tear: Causes, What to Expect and 4 Tips for Faster Recovery

When a woman has intercourse or gives birth, there is a chance that she will suffer from a perineum tear. And as you can imagine, a tearing of any kind can be very painful and can ruin even the most intense and intimate moments.

Painful intercourse can be caused by a variety of different factors:

  • Cysts
  • Endometriosis
  • Lack of lubrication

But a perineum tear can be another cause of painful intercourse, and it is quite painful.

What is a Perineum Tear?

A perineum tear is a tear that occurs when having vaginal sex or when delivering a baby. Severe in nature, these are third and fourth degree lacerations. The degree of the tear will have different consequences.

  • Third-degree Laceration: A third-degree laceration occurs when there is a tear in the vaginal tissue. The tissue is called perineal skin, and the perineal muscles lead from the vagina all the way into the anal sphincter.
  • Fourth-degree Laceration: A fourth-degree laceration is very serious and occurs when the tear not only happens in the vagina, but makes its way through to the anal sphincter and the surrounding tissue.

Women can also have tearing in other areas of the vagina, such as the top of the vagina.

Facts About Tears

  • Small tears may require stitches, or these small tears may be minor enough that they heal on their own over time.
  • If tears don’t involve any muscle tissue, they will heal much faster.

Causes of a Perineum Tear

A perineum tear can be caused by a lot of different things. But there are two root causes for most tears:

Giving Birth

Birth is very difficult on the body, and delivering a larger baby does have consequences. One of these consequences is the tearing of the vagina and surrounding tissue. And many women that give birth for the first time will have perineum tears.

Serious tears can occur when:

  • You have given birth to a baby that is face up in the posterior position
  • Your baby is very large
  • You push for a long time during labor
  • Forceps or other devices were used in an assisted birth

There are also abnormalities that can cause tearing. If there is a smaller distance between the vagina and anus, this can cause tearing when giving birth, too.

The good news is that when you have a tear during pregnancy, your doctor will be able to offer his or her assistance. If the tear is minor, you’ll likely go home with a minor pain reliever or an antibiotic to ensure that infection does not occur during the healing process.

In the event that the perineum tear is very serious, you may need stitches. The stitches will stay in for under two weeks in most cases, and the tear will heal in this time period.

Sexual Intercourse

Sexual intercourse can cause a perineum tear. The vagina will naturally lubricate itself so that the penis can enter the vagina without tearing occurring. But there are times when a woman may not be in the mood, so the lubrication isn’t ideal.

But there are other reasons that sexual intercourse can cause tearing:

  • Various positions can put undue stress on the lining of the vagina and cause tearing
  • An abnormally large penis or small vagina can cause a woman’s vagina to tear during sex
  • Vigorous intercourse can lead to tearing if the thrusting is too intense

You may also use toys or items that are too big for the vagina that can cause a tear to occur. A smart way to avoid tearing is to use a generous amount of lubrication that will allow for easy entry into the vagina without too much rubbing or risk of tearing.

It’s important to note that a woman may have an abnormally thin lining that can be torn more easily than normal, which can lead to tearing even during rather gentle intercourse.

4 Recovery Tips for Anyone with a Perineum Tear

Under normal circumstances, your tear will heal within a few weeks without much concern for infection or long-lasting effects. With that said, it’s important to know a few tips and facts that will accompany the recovery process:

  1. Going to the bathroom will be painful. Bowel movements and urination will be painful, and your doctor can prescribe a stool softener that will alleviate much of this pain.
  2. Constipation can occur if you don’t go to the bathroom because of the pain. While painful, you still need to go.
  3. Avoid sexual intercourse until your doctor approves. If you continue to have sexual intercourse, the tear will not be able to heal and may even become worse.
  4. Avoid inserting any items into the rectum, including enemas or suppositories.

Small tears are not much of a concern, but if the pain persists for more than a week, you may want to contact a medical professional. If you’re giving birth and a tear occurs, your doctor will likely give you stitches and advise you on what steps to take next.