How Do I Stop Perineal (Perineum) Pain?

Perineal pain treatment may vary depending on the underlying condition. Sometimes, the treatment varies in men and women:

• Get adequate rest.
• In cases of perineal pain caused by perineum tear or episiotomy, regular sitz baths, numbing spray, and pain reliever drugs may provide temporary relief. 
• Antibiotics can help treat certain types of perineal pain.
• Pelvic floor massage therapy helps manage long-term pain.

Perineal pain includes a physical and medical examination. The doctor may recommend special tests depending on the underlying cause of the condition.

Common diagnostic tests include:

• Blood tests
• Urine analysis
• Radiological evaluation or ultrasound

Most men and women who experience perineal pain display symptoms, such as:

• Burning sensation in the perineum
• Severe perineal pain
• Lower abdominal pain
• Genital pain
• Anal pain
• Pelvic pain

Additional symptoms in women

• Painful urination
• Vaginal discharge
• Burning sensation
• Soreness
• Pain during intercourse

Additional symptoms in men

• Bladder pain
• Frequent urination
• Tailbone pain

The causes of perineum pain differ in men and women, but a few causes remain the same in both genders.

Tears during childbirth

Most women experience perineal tears during the delivery of the first child. A few women may get severe tears, which may extend to the vagina.

These perineal tears are very painful that may cause severe discomfort while performing regular activities, such as walking and sitting.

Regular sitz baths with anesthetic sprays and cold packs may help relieve pain. If a woman develops a fever, severe pain, a foul odor, or any fluid discharge from the tear, they should immediately consult their doctor and seek medical attention. They should use pelvic floor massage therapy to avoid chronic pain after the tear heals.

Episiotomy

An episiotomy is a common procedure where doctors make an incision or cut to extend the vaginal opening during childbirth. Episiotomy pain is almost similar to the pain during perineum tear. In a few cases, the episiotomy may cause injury to adjacent areas, possibly leading to surgery. Due to this, a few experts are recommending avoiding routine episiotomies.

Regular sitz baths, numbing spray, and pain reliever drugs may provide relief from the pain for a short duration. Pelvic floor massage therapy helps manage long-term pain.

Other perineal injuries

Both men and women experience perineal injuries. Trauma caused by a fall or an assault can damage the muscles of the perineum, causing severe pain. Medical conditions, such as diabetes, can damage the nerve, resulting in severe pain.

Pelvic floor dysfunction

Pelvic floor muscles provide support to pelvic organs, such as the urinary bladder. Pelvic pain can affect both men and women. However, it is most common in women after giving birth. In pelvic floor dysfunction, the muscles become stiff, causing muscle tension and pain. In women, urinary incontinence (a sudden urge to urinate and involuntarily passing urine) results from muscle weakness.

Pelvic floor exercises and massages can help treat pelvic floor dysfunction.

Hemorrhoids

Hemorrhoids are swollen blood vessels in the anus that causes bleeding during bowel movements. Some hemorrhoids cause pain in the perineum due to increased pressure.

Regular sitz baths after each bowel movement and using hemorrhoid cream provide some pain relief. Drinking plenty of water and having a high-fiber diet may relieve constipation.

Prostatitis

Prostatitis is an inflammation of the prostate that results in pain in the perineum. This inflammation occurs suddenly due to infection or injury and could cause long-term pain. In cases of infections, antibiotics are used to treat the condition. If the person experiences pain while urination or having sex, they should immediately consult a doctor.

Infections

Any abscess or cyst in the anal region or perineum may cause perineal pain. This area becomes swollen, red, and painful.

Numbing sprays, pain relievers, and antibiotics may help treat the infections.