Vaginal tearing, or perineal lacerations, can occur at any time in a vagina owner’s lifetime, for various reasons. This type of laceration or tear can happen anywhere in or around the vagina and vulva, most often occurring around the vaginal opening and through the perineum. The perineum is the space between the vagina and anus.
Some of the most common causes of vaginal tearing are:
- Sexual intercourse
- Tampon insertion
- Gynecological exams
- Fragile skin from chemotherapy, radiation, or other heavy medications
- Vaginal births
- The use of forceps or a vacuum for birth
- Waxing or shaving pubic hair
Levels of Vaginal Lacerations & Tears
After a laceration has been found, it is best to determine the severity of the wound. This can help the vagina owner better understand if their wound can be taken care of at home, or if they may need medical intervention to help them heal.
- First-degree tear. A first-degree tear causes issue to the first layer of tissue on the skin of the vagina. This is the most minor type of laceration. These tears are common in patients who are on or have completed chemotherapy, radiation treatments, or long-term medication use.
- Second-degree tear. This type of tear extends in to the skin and muscular tissue of the vagina. This is the most common type of tear in childbirth (CDC/NIH).
- Third-degree tear. This third-degree laceration extends from the anus to the vagina. This injury affects the skin and muscular tissue of the perineal area as well as the anal and sphincter areas. This is an extremely painful laceration.
- Fourth-degree tear. This rare, extreme tear occurs from the vagina, into the anus, and through the rectum. This is most often seen in childbirth but is a rarity at that.
Treating a Vaginal Laceration
Treatment for your vaginal tear will depend on the overall severity of the injury itself and the location. For a first-degree tear, typically no stitches are needed. In those second, third, and fourth-degree tears, it is possible you may need stitches and medicated or prescription creams to control any infection and pain.
If stitches are needed, doctors most often use dissolvable stitches to reduce more irritation and to make the healing process flow smoothly, usually within six weeks. There will be discomfort during your time of healing which will be “worse” depending on the level of your tear.
Your doctor may advise you to do one or more of the following:
- Using prescription pain creams
- Using antibiotic creams directly to the wound
- Taking prescription pills
- Using a peri-bottle squirt bottle to wash and clean yourself after each bathroom use
- Gently using clean towels to pay yourself dry instead of wiping
- To avoid becoming constipated by drinking plenty of water and using a stool softener
- Prescribe or suggest cooling pads to wear with your pads after a vaginal delivery
- Using a silicone-hybrid lubrication during any type of intimate touch or sexual activity
- After healing, using dilator therapy to help to restore natural vaginal function
Patients typically report that it takes roughly two weeks to begin to feel relief and generally feeling better in the area. If you notice any signs of infection, do not wait to contact your doctor or medical care team. These things would be:
- A fever
- Pain that does not go away, even with medication
- Any foul smelling discharge
If you notice pain with intercourse after a few weeks of treatment or pelvic rest, do consult your doctor again for a follow-up.
If you notice a low-level vaginal laceration, consider these tips for home care:
- Only touch the wound or area with clean hands
- Wash the affected area with unscented soap and water only
- Avoid soaking the area in water
- Keep the area as dry as possible
- Apply an ice pack to the area to reduce inflammation and pain
- Use a pillow for sitting if uncomfortable
- Do not use products inside the vagina while healing
- Avoid any products that change the pH of the vagina
It is not always possible to prevent vaginal lacerations, but important to try to take care of this very sensitive and reactive tissue area. Especially for those patients who face thinning genital skin from cancer and long-term illness treatment. If you suspect your vaginal skin is thinning or you have a laceration, do not wait to seek out treatment and begin to care for the area. If you suffer from chronically dry vaginal tissues, consider using a natural daily moisturizer!