Vaginal tears: everything you need to know, from causes to treatment

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Vaginal tearing: everything you need to knowPHILIPP NEMENZ - Getty Images

Of all the places to get a cut, this is probably last on your list – but vaginal tears are actually very common. And no - they aren't just something that happen to people who've given birth vaginally, as opposed to having a c-section. They can occur for a number of reasons, and are mostly nothing to worry about.

(Side note: as with most things gynaecological, often the incorrect terminology is used and what are commonly called 'vaginal tears', are actually 'vulval tears'). Whilst the skin can be torn inside the vagina, it's relatively uncommon – most tears appear on the vulval skin outside of the vagina. But, for the purpose of this piece and for what many people feel most comfortable with saying, we'll use both vaginal and vulval tears throughout.

As Dr Claire Bailey, a Consultant Gynaecologist who specialises in vulval disorders, explains, although vulval tears can appear to be minor, they can cause severe pain and consequently have a negative impact on a woman’s ability to enjoy sex. Meaning, it's important to try and work out what might be causing a tear in the vaginal region and figure out how best to treat - or prevent them - in future.

We also spoke to Dr. Tiffany Pham (DO), board-certified OB-GYN and medical advisor at Flo Health about vagina tears, what causes them and what we can do if we find ourselves struggling with them.

What causes vaginal tears?

The big bad tears we hear about are usually associated with childbirth, but it's common to get smaller, less visible tears on your vagina or vulva for a number of non-baby related reasons. Joy!

"Vaginal tears can be caused by trauma in addition to childbirth," Dr Pham explains. "The trauma can be the result of penetrative sex or the use of devices or objects during intercourse. Trauma can also occur from falls, bike accidents, or vehicle accidents."

Primarily, says Dr Bailey, it comes down to lubrication - the holy grail of vaginal interaction. The skin around your vagina, vaginal walls and inside your labia is sensitive and if you're having sex or doing anything down there without sufficient lubrication the skin cannot move against friction and instead will be pulled until it tears. It's all about avoiding trauma to reduce the risk of vulval or vaginal tears after sex.

"Arousal for women is complex and it is important that a woman is lubricated prior to attempting penetration," the expert explains. "At certain times in a woman’s life vaginal dryness may be more problematic, such as when approaching the menopause or during breastfeeding. Most tears occur just at the entrance of the bottom of the vagina and extend to the perineum (the skin between the vagina and anus)."

The incorrect use of tampons, shaving and masturbating without enough lubrication (or by using a sex toy that is too large for you to accommodate) can also be a culprit.

Often, you'll feel a sharp pain as these micro tears happen, but it is possible not to realise until after the act, at which point you might feel slight discomfort the next time you touch the area, find some light bleeding or notice it stings when you pee, have sex or insert a tampon.

Tearing with sex can happen to anyone but inadequate natural lubrication from hypoarousal, not not using enough lubricant or sexual positions that put additional strain on the perineum (like having sex from behind), can all increase the risk of experiencing cause vulval perineal tears," says Dr Bailey.

It may be obvious if a tear occurs during intercourse but sex is not the only time women can suffer from splitting skin on the vulva, she adds. "It is important to exclude other causes for vulval tears, in particular thrush infections and inflammatory vulval skin disorders."

A perineal tear should heal within six weeks, during which time you may experience feelings of discomfort, especially when urinating and sitting.

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How can you heal vaginal tears?

The vagina is a self-healing, all round efficient body part, so most micro-tears will heal themselves within a few days.

"Small vaginal tears will often heal on their own within 1-2 weeks," explains Dr Pham.

"It can be useful to apply a barrier cream, such as Petroleum jelly, to the tear to soothe and protect the area. Some bigger tears, however, will take longer to heal and a doctor may prescribe topical steroid to reduce local inflammation," Dr Bailey notes, adding that she would also recommend investing in some Bio-Oil:

"Having applied some to your finger, massage the lower entrance of the vagina in a 'U' shape for a few minutes every day," she says. "Although this is not a 'quick fix', over time (a few weeks), the elasticity of the skin improves which reduces risk of tearing along with increased blood flow which is a fantastic way of supplying the area with more healing white blood cells."

Despite these measures, some women find that these tears re-open every time they have sex. "When this interferes in a woman’s ability to have sex, it is reasonable to consider a small operation to surgically excise the tear," adds Dr Bailey, also saying that it's worth remembering that tears can also occur within the vagina.

"This is more likely to occur with rougher sex or use of vibrators or other objects entering the vagina. The vagina tends to bleed more than the vulva so a large tear in the vagina can result in significant bleeding." If you notice the pain is getting worse or you are bleeding excessively then it's important to seek medical help right away.

"If you are experiencing persistent vaginal pain after intercourse or after any traumatic event to the pelvis, you should consult your doctor for an evaluation of the vagina," says Dr Pham. "If you experience heavy or persistent vaginal bleeding, pelvic pressure, pressure in the vagina, or feel a bulge in the vagina after sex or suffering any injury to the pelvic area, you should also see your doctor for a physical exam and evaluation."

Avoid sexual activity and inserting tampons until a doctor has okayed it, too.

How can you prevent vaginal tearing?

We can't stress it enough: lubrication, lubrication, lubrication. Put simply, whatever you're doing the biggest risk of vaginal tears is from a lack of lubrication. It also puts you at pretty big risk of having rubbish sex... so lube up, whether you think you need to or not.

"The use of lubricants during penetrative sex or use of devices or objects during intercourse can help decrease the risk of tearing," says Dr Pham. "Try to avoid causing trauma to the vagina by ensuring that you are properly aroused and lubricated during intercourse or when using devices for pleasure. Ensure that fingernails are properly trimmed if you are utilising fingers for foreplay or intercourse."

Never rush straight into penetration either – that's a really good way to tear yourself a new one, literally – and in general, whether you're shaving or inserting a tampon, try to be gentle.

When should you see your GP for a vaginal tear?

Vulval/vaginal tears are totally normal and pretty common, and like we said, they tend to clear up on their own without specific treatment. But if you're concerned, the general rule of thumb is go to your doctor – after all, that's what they're there for.

According to Dr Bailey, "Vulval tears are usually an inconvenience rather than anything serious but we should not underestimate how bothersome they can be, particularly when they impact on sex. If simple measures do not seem to be working then seek medical advice to confirm the diagnosis."

Above all, the main thing to remember is that if it's happened to you it's probably happened to someone else. We're all just trying to understand our bodies, one confusing change at a time.

This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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