What is Perineum Pain?

The perineum is a major area of muscle attachment, which makes it one of the most common sites of pain. Perineum pain can affect any man or woman. The perineal region includes the space between the genitals and anus. Pain can occur in the perineum because of nearby organs, muscles, and nerves.

All Sexes

Anyone of any gender can experience perineum pain. The pain can result from injury, infection, or other health conditions such as diabetes. Individuals of any age can feel perineum pain.

Men

In males, the perineum is the space between the scrotum and anus. A swollen or inflamed prostate can lead to perineum pain in men.

Women

In women, the perineum is the space between the vaginal opening and anus. Women are particularly vulnerable to perineum pain because of childbirth and urinary tract infections. Perineum pain in women can also feel sore and itchy.

Signs and Symptoms

There are several common perineum pain symptoms. Some of these symptoms are the same for both men and women. For example, both men and women may experience a burning sensation in the perineum, as well as lower abdominal pain. Genital pain, anal pain, pelvic pain, and lower back pain are all common among all genders. Men and women might also experience pain when sitting.

Women will often also have additional symptoms of vaginal discharge or painful urination due to these conditions. Women can experience burning, soreness, and itchy perineum pain. Sexual pain during intercourse, during orgasm, and after sex can also occur.

Perineum pain symptoms in men include bladder pain, more frequent urination, and tailbone pain.

Causes

The cause of perineum pain can differ between men and women. However, some perineum pain causes remain the same across genders.

All Sexes

The following conditions can cause perineum pain in men and women:

• Injuries — Minor injuries to the groin can cause perineum pain. Injuries can occur from falls, accidents, or strikes to the groin.
• Pelvic floor dysfunction — Pelvic floor dysfunction happens when your pelvic muscles are not working properly. Experts are not entirely sure why this happens. They suspect that something weakened or tore your muscles such as having a baby or surgery in the pelvic area.
• Hemorrhoids — Hemorrhoids can cause perineum pain. Hemorrhoids are varicose veins in the anus or rectum. They usually develop because of increased pressure and straining while passing stool, pregnancy, or heavy lifting.
• Interstitial cystitis — Interstitial cystitis is a long-lasting condition that can cause pain and pressure in your bladder. Perineum pain can occur because of a malfunction of your pelvic nerves. Your body tells you that you need to urinate all day and night even though your bladder is not full.
• Pudendal nerve entrapment — This is nerve damage in your pelvis. Surrounding muscle or tissue compresses the nerve, causing pain.
• Abscess — An abscess is a medical condition in which bacteria and other infection-causing agents propagate to create an irritating pouch of pus. An abscess can form on your perineum or in a nearby area.
• Urinary Tract Infections (UTIs) — A urinary tract infection is an infection that happens in any part of your urinary system, such as the urethra or bladder. Most UTIs affect the lower urinary tract. UTIs develop when bacteria infiltrate your body through your urethra and cause an infection in this region.

Men

Prostatitis is pain and inflammation of the prostate gland. It can be acute or chronic, but it is usually a temporary problem that resolves within six weeks to two years. Pain may range from mild discomfort to severe agony, often worsening at nighttime. Other symptoms include difficulty urinating (dribbling urine), painful ejaculation or orgasm, and frequent waking up at night to urinate. Prostatitis can also cause perineum pain in men.

Women

There are several causes of perineum pain specific to females:

• Childbirth — Childbirth can cause pelvic floor dysfunction that leads to perineum pain during sex. During childbirth, your doctor may perform an episiotomy by making a small incision to the perineum. This allows more room for the baby to move through the birth canal. The perineum might also tear during delivery.
• Vulvodynia — Vulvodynia is a condition in which the vulva (clitoris, labia minora and majora) hurt without any obvious reasons. Vulvar pain may be caused by localized injury, such as from sexual intercourse or wearing tight clothes.

Diagnosis

Perineum pain diagnoses involves a routine medical exam, a discussion of your symptoms, and other medical tests. The specific test your doctor performs depends on the underlying medical problem they suspect. There are many possible reasons for perineum pain in men and perineum pain in women.

Common diagnostic tests include:

• Blood tests — Blood tests will tell doctors if there is a problem with your blood that is causing pain in the perineum. Your doctor will usually check for infections and analyze your blood cell count.
• Urinalysis — A urinalysis will tell doctors if you have a urinary tract infection.
• Radiological evaluation or ultrasound — These tests allow doctors to see if there is an abnormality such as a tumor, cyst, or other mass that may be causing your pain.

Treatment

Perineum pain treatment varies based on the underlying condition causing the pain. Perineum pain female treatment is sometimes different than perineum pain male treatment.

The most common treatment is rest. Rest allows the body to repair any damage and heal itself. Antibiotics can also help heal certain types of perineum pain. Perineal massage is a type of physical therapy that can help with pelvic pain, but it should be postponed until any inflammation subsides.

Perineal massage can be used to help alleviate pain due to hemorrhoids, constipation, perineum tearing, anal fissures, and other conditions.

Perineal pads, also called sanitary napkins, are sometimes used to protect underwear from blood after giving birth, when having difficulty controlling bowel movements, or to protect a wound to the perineum.