Vaginal Cut Causes and How to Treat Vaginal Tearing after Childbirth, Menopause

3.2K

Vaginal tearing and vaginal cuts can cause pain and discomfort. They occur mostly after childbirth and in menopause. When not taken good care of, perineal fissures can lead to infections in the genital area. Here are the causes, treatments and home remedies to heal vulvar tears and cuts.

What is a vaginal cut or vaginal tearing? “A vaginal or labial cut or tear (fissure) is a painful split, crack or break in the mucous membrane (skin) inside the vagina, on the inner or outer labia (vulva), on the perineum, or around the clitoris or clitoral hood.”

See also: What causes an itchy vagina? 12 causes and treatments.

Vaginal tearing is a very spontaneous laceration to the perineum (which is the area between the vagina and the rectum) that happens when the baby is being pushed out. During childbirth, the vagina must stretch enough so as to allow a baby, whose head is always of bigger size, to come through it.

• First-time moms have a higher percentage chance of having some form of vaginal tearing especially during child delivery, since the tissue at the vagina is less flexible.

Vaginal tearing causes

Other factors may contribute to the likelihood of the lacerations, such as being overweight or even having a fast birth, since the tissue has much less time that can be able to adapt and even stretch when the baby comes down; the position of the baby (those facing up, for instance, put much extra pressure on the bottom part of the vagina) is also another factor.

Having a vacuum- or even forceps-assisted delivery or especially long labor that leads to severe vaginal swelling increases the chance of vaginal tearing as well.

1. Vaginal cuts and tearing during childbirth

When a person is giving birth, a new human is coming out through the vagina, so it shouldn’t surprise you that the vaginal delivery needs it to stretch. Every other person who delivers through the vagina (and sometimes people who have a lengthy labor before delivering through cesarean) might expect some of the perineal postpartum pain.

And it’s very common, given the pressure from the baby’s head that is pushing through, to have vaginal tearing as well as lacerations in the perineum (this is the area between the vagina and the anus) and sometimes the cervix also. As most of the women will have at least a small tear after the childbirth, and anyone who is delivering vaginally is also at risk.

2. Itchy vagina and scratching

Pruritus vulvae implies itching of the vulva. The vulva is the area of the skin that is just outside the vagina. Most of the women have a slight vulval itch most of the times. But, pruritus vulvae implies the itch is persistent, and leads to distress.

The itch can be particularly very bad especially at night and may disturb the sleep. About 1 woman in every 10 visits a doctor about the persistent itchy vulva at some stage in her life. Vulval itching may also affect any woman, at any age. It can also cause scratching and rubbing that might break the skin and can cause soreness, bleeding as well as skin infections.

3. Rough sexual intercourse

After experiencing a rough but very pleasurable sex with a loved one, sometimes you can feel a burning sensation in or even around the vagina that is accompanied with a localized soreness and pain.

This discomforting condition normally worsens when you try to urinate or even when the urine wets the affected area. In fact, sitting on the flat surface might also aggravate the discomfort. Don’t be worried too much, it can be just vaginal tearing.

Engaging in a very vigorous sexual intercourse with a dry and not adequately lubricated vagina is one of the most frequently cause of a vaginal tearing. Sometimes, the inappropriate usage of sex toys can also destroy the vaginal walls and may cause lacerations.

4. Sports e.g. skiing

Sports activities including jet skiing, water skiing may also put much pressure on the vagina, which increases the risk of vaginal tearing.

5. Vaginal Tears in Menopause

Physiological aging makes very serious changes in the body of a woman that can affect the anatomy, physiology as well as metabolism of the tissues.

For instance, menopause or any other causes of hormonal imbalance may significantly increase the risk of vaginal tearing by bringing down estrogen levels, also impairing blood circulation, thinning of the skin, irritating or even weakening the healing of old scars, etc.

Types of vaginal tears

There are up to 4 types of vaginal tearing or vaginal cuts. Each degree has a different level of cut or severity of the wound.

1^st degree tear

(This is where only the skin is much torn) and second-degree tears (where the skin and vaginal muscle are much torn) are the most common types of vaginal tearing.

• Perineal and the vaginal tears may sometimes lead to a lot of pain and can increase the recovery time.
• In many cases, a tear needs stitches (they’re generally needed in tears that are longer than 2 cm, or even about 1 inch). After the tear is fully repaired, a person will likely have tenderness at the spot as it heals.

Like any other freshly-repaired wound, the area of a laceration or even the episiotomy will take time to heal, normally seven to about14 days. The wound will most likely hurt for many weeks, so you will have to take it easy in the meantime.

This tear is also a thin tear of the perineal skin. No muscles are in any way involved. It is very possible that a small number of the stitches can be required

2^nd degree tears on vagina

This the most frequent laceration, the vaginal tearing involves the lining as well as the deeper (sub mucosal) tissues of the vagina and need for more stitches. The tear also includes skin as well as the muscle tissue.

• Stitches are normally required and it might take around two months to feel completely comfortable again.

An episiotomy is a cut that is made into the perineum to enlarge the vaginal opening. This is done to assist the baby be born. An episiotomy however involves the same muscle and tissue as a 2nd degree tear on the vagina. However some of the episiotomies might extend further, and when this occurs they might be described as a 3rd or even a 4th degree tear entirely depending on their severity.

3rd degree tear

This type of laceration goes into the deeper layers of the vagina and the muscles that always make up the anal sphincter. The doctor might be required to sew each of the layers separately, with the special attention paid to closing the muscle layer that is supporting the sphincter.

This vaginal cut, tearing or laceration through the perineal muscles as well as the muscle layer that surrounds the anal canal.

• This needs to be stitched and may take a similar time to a 2nd degree tear (three months or so), if not longer, before the wound is fully healed and the area is much comfortable.

4th degree tear

This type of a deep vaginal cut or tearing involves all of the above and also extends right through to the rectal lining. This is a very much delicate and thorough repair that has closing multiple layers. Thankfully, this is the least of the common tear that is experienced. Normally, third- and fourth-degree tears are very common when the baby’s shoulder gets stuck or even when a vacuum or the forceps are applied.

• This tear also goes through the anal sphincter all the way to the anal canal or even the rectum.
• Most of the women who have the condition will have none of the ongoing problems, with the best management (including very good personal hygiene by you, diet, physiotherapy, pain medication as well as laxatives).

However some women may have problems with controlling of the passing of urine, wind or even feces. This is known as incontinence (urinary and fecal incontinence) and will need ongoing clinical review or even medical consultation.

Also, although there are much more uncommon than a tear, a recto-vaginal fistula can also develop. This is when the tube-like passage links the vagina and the rectum. Signs of this are the passing of flatus and faeces through the vagina.

• It is very crucial that you tell the doctor if you have either of these symptoms as infection might result.

Third and fourth degree tears or fissures of the vagina are a very uncommon complication of the child birth that can affect a woman’s normal bowel, the bladder as well as sexual functions short term and in some other cases, permanently.

If you experience a first- or even a second-degree tear, you might expect some discomfort—especially if you’re sitting straight up—for one week or so. Experiencing a bowel movement or even doing anything that leads to an increase of the downward pressure, such as coughing or even sneezing, will hurt, also.

By the second week, the tear should be well healed and the stitches to have dissolved, but the nerves and the full strength of muscles might take several more weeks so as to heal, (Sex at the first six weeks can likely be uncomfortable, depending on the location of the tear as well as the the quality of the stitching.

• Healing for third- and fourth-degree lacerations takes longer period of time, with two to about three weeks of initial pain.
• The discomfort during sex, or while having a bowel movement, may last for many months.

Stool softeners as well as a diet of fiber-rich foods might help with the latter, as can cold compresses and herbal sitz baths. Since more severe tears into the vagina or even the rectum can lead to pelvic floor dysfunction as well as the prolapse, urinary problems, bowel movement difficulties, and the discomfort that comes during intercourse, it’s very important to share all of the symptoms with your doctor, no matter how embarrassing they can be.

Vaginal Wall Tears Symptoms

Many women that present with posterior vaginal tearing and cuts are normally sexually active and symptoms also follow intercourse. Symptoms can be very mild, moderate or even severe in intensity, and can resolve within a few number of days.

• Pain on the vaginal penetration during intercourse
• Pain on insertion of the vaginal tampon
• Pain even during vaginal examination
• Tearing sensation
• Bleeding or spotting
• Itching in the vagina
• Burning feeling in the vagina
• Stinging on contact with semen, water or urine or any other liquid.

Affected women can be premenopausal or even postmenopausal. Vaginal tearing might happen at the first attempt at sexual intercourse or even many years later, in the women who have had children or who have never had any children. They can also have other symptoms that includes fissures in the skin folds elsewhere in the vulva.

On careful clinical evaluation, there is normally a tiny split or even a linear erosion at the midline of the base of the vagina on the perineal skin. Colposcopy (which is the magnification with a bright light) can be very necessary to see the fissure.

The posterior fourchette can then form a tight band or even the tent (membranous hypertrophy). In some other cases, signs can be much more impressive and include:

• Marked tenderness
• Deep, wide ulceration of the vaginal walls
• Redness of the surrounding tissue
• Swelling or lumps
• Scarring

The vulva can also appear very normal if the examination takes place after the fissure has completely healed. But usually, a new fissure can be observed to appear while gently stretching the inside of the vulva.

How to Treat Vaginal Cuts Tears

You can expect some kind of discomfort, bleeding, and the swelling following a delivery as well as a vaginal tearing. With the doctor’s permission, there are several other ways you can relieve the discomfort at home and even encourage healing. These are:

1. Applying ice packs

Applying ice packs especially to the affected area for about 20 minutes at a time might assist to reduce swelling. Many of the drugstores sell the ice packs that look like sanitary pads that are normally snapped so as to release materials that turn very cold.

• These may be worn in the underwear. If you use an ice pack, ensure that it has a clean cloth cover over it to so as to protect the skin from damage from the cold.
• Make sure that you not to use an ice pack for more than 30 minutes at a time, as it can lead to nerve damage.

2. Taking a stool softener

The doctor can also prescribe a stool softener or even recommend an over-the-counter stool softener, like the docusate sodium (Colace). This can reduce the need to strain when you have the bowel movement. You shouldn’t resist a bowel movement if you feel it.

Vaginal tear recovery and healing

The treatment as well as the healing or recovery for the vaginal tearing always depend on the degree of the laceration. First degree tears are very superficial lacerations of the skin that are found in the vagina. Second degree tears consists of the skin and fat tissue under the skin.

Third degree and the fourth lacerations involve the deeper muscles in the vaginal wall. These lacerations can lead to lot of bleeding, requiring surgical repair. Thereafter, proper care has to be taken to help speed up the recovery and healing process of the vaginal cuts and tears.

Perineal tear not healing

Healing times following vaginal tearing vary from one woman to another, but in general, the deeper the cut or the tear, the longer the recovery time. A small, first-degree tear involves the skin rather than the muscles, and it cannot even need stitches. The tears normally heal very quickly and lead to little discomfort.

If you have a very serious tear that extends much to the rectum (a third- or fourth-degree laceration), you can have the pain and the discomfort for one month or even longer. (The tears happen to anyone, but are likely to happen if you have an episiotomy.) In the very first few days after birth, you may have trouble on urinating and passing bowel movements.

How to prevent vaginal tearing

During delivery time, try to get into a good position that puts very less pressure on the perineum and the vaginal floor, like the upright squatting or even side-lying. Hands-and-knees and even other more forward-leaning positions may reduce vaginal tearing, too.

It also assists if you lead the pushing stage of labor. On the flip side, when the mom is directed to push as hard as she can while someone counts, then there’s a lot of additional pressure on the perineum, which might increase chances of vaginal tearing.

In addition, you may reduce the odds of the tearing by using a warm compress to the perineum during the pushing phase of labor.

Finally, about four to six weeks before the due date, a mother needs to practice a about 10- to 15-minute perineal massage daily. Frequently massaging the base of the vagina using oil or even water-based lubricant is said to soften the tissue, thus making it very supple and even improving its flexibility. Always consult the doctor before starting the practice, more especially if you have a history of herpes, as the practicing perineal massage with an active herpes outbreak can increase the risk of the virus spreading around the genital tract.

How to tell what’s going on based on feeling

Sores feel very different, ulcers also feel different, bumps equally feel different. Think about how the mouth feels when you damage it or when you get an ulcer, and even compare the sensations – it’s the same sort of tissue that is inside the vagina, with the mouth lips about the same sort of tissue as the inner labia lips. Outer labia skin is similar to regular skin.

You are required to make sure it is not a sore, blister, lesion, or growth as these sorts of problems are normally caused by the infections or any other medical conditions, and leaving them alone to heal isn’t going to work.

When to see a doctor

You are required to be checked out if the cuts or even the vaginal tearing don’t heal, seem infected, you have abnormal discharge or are in much pain that isn’t abating.

Treating vaginal fissures and cuts

This is normally treated as you a sore in the mouth. It is in raw mucous membrane and requires to be treated, so no harsh anything. If you have compromised wound-healing abilities (like the diabetes, low nutrient status) or even the immunity (HIV, chronic illness), it might take a bit longer for the cuts and tears to heal.

1. Don’t Douche

Don’t douche with anything, as you might upset the natural balance of the bacteria that protects the vaginal mucous membranes and keep the vagina very healthy. You have a bacteria that have a symbiotic relationship with mucous membranes.

You may have an infection of a kind anyway, but that requires to be dealt with in any other way, douching cannot get rid of an infection of any kind.

2. Avoid sexual intercourse

Sex and fiddling is out. Don’t have sex until the scrapes and cuts are properly healed, as otherwise you may just re-open a newly-closed flesh, thus sustaining the wound.

Intercourse, however gentle, can build up into a rough experience especially when you have a cut that is fresh or even one that is already healing.

3. Avoid irritants on vaginal cuts

Don’t irritate the vulva or vagina by use of the tampons, diaphragms, condoms or any other vaginal devices, lotions or potions until you are properly healed. No scratching, masturbating or even tight underwear.

• Irritants can make the area itchy and encourage scratching. Scratching can easily worsen the tear, fissure or cut and prolong the healing time.

4. Genital hygiene

Make sure that you wash your vaginal area gently, daily. Do not use harsh, drying soaps that might strip the delicate skin of the moisture. Don’t try to be rough – the skin stitches its proteins together as it heals, and if you are very rough, it might pull them apart.

Your fatty protective layer is a friend. Don’t try to wash it off. It performs just the same as, say, diaper rash – continually stripping the skin of its natural protective layer implies it can’t do its job.

4. Use mild soap

Soap – make it very hypoallergenic, free from the known irritants. Do not try to use soap in the vaginal opening, ever. Stick to the outer labial folds.

• The vaginal mucous membranes (like the nose and lungs) do not require washing.

5. Soothe vulvar fissures

Soothe vulvar fissures (outside labial skin only) using a small amount of healing aloe vera gel, pawpaw ointment, vitamin E oil or other non-antibacterial soothing oil (you want to preserve the good bacteria).

Do not try to insert any creams or even gels into the vagina unless it is prescribed by the physician, particularly antibacterial creams. Your mucous membranes will be irritated and you will end up with vaginal rashes and bumps.

• If the labia are very itchy, dry or even tender, try a warm oatmeal bath – oats are soothing to the skin. They also reduce itching and inflammation, and generally make a person feel nice.

6. Eat a balanced diet

You are literally growing new skin and patching up wounds, so having a healthy and well-balanced diet will help your skin heal quickly. If you build your temple out of soda and takeaways, don’t expect healthy, strong skin including on your vulva. It matters.

Perineal tear infection

Your recovering body may be much vulnerable to some infections after you have a baby. Some of the postpartum infections normally starts brewing during labor, though they normally don’t become apparent for several days – or even weeks – after delivery.

Common infections are:

• Endometritis, an infection of endometrium (which is uterine lining)
• Infected incision
• Urinary tract infection

Here’s a video on vaginal fissures, cuts and tears.

Sources and references

1. Itchy Vulva (Pruritus Vulvae): http://patient.info/health/itchy-vulva-pruritus-vulvae
2. Vulval itching: http://www.embarrassingproblems.com/problem/vaginal-vulva-problems/vulval-itching
3. Postpartum perineal pain: http://www.babycenter.com/0_postpartum-perineal-pain_256.bc
4. Taking Care of Vaginal Tears After Delivery: http://www.healthline.com/health/pregnancy/treatment-vaginal-cervical-lacerations#Overview1
5. Vaginal Tearing: Treatment and Prevention: http://www.med-health.net/Vaginal-Tear-Treatment.html
6. Recurrent fissuring of posterior fourchette: http://dermnetnz.org/site-age-specific/fissured-fourchette.html
7. Vaginal Tear (Non-Obstetric): https://www.fairview.org/HealthLibrary/Article/116680EN