Aunt Vadge: bicycle accident has left my labia torn – what do I do?

Dear Aunt Vadge, 

What time is vag o’clock?  Also, where are you getting all of your information?

OK, on a serious note.  Today I took an unfortunate bike ride, that ended in my vagina slamming into the crossbar of the bike when the brakes stopped working and I found myself hurdling into an intersection (there was no other way to slow down other than flinging my body weight into the pavement and unfortunately all the impact landed on my labia!).

Needless to say, there was a lot of blood.  At first, my friends thought I broke my hymen. But, upon further inspection, it is clear that there is a cut (AKA vaginal fissure) on the right side of my inner labia.

How should I take care of this?  Should I see a doctor?

Help, Aunt Vadge!
Love,
Biked

______

Hi there Biked,

Your accident sounds really painful! And messy. Because your fissure has been caused by an accident, you will need to self-assess with some care. You sound like you have fabulous friends who have inspected the damage, so here are my thoughts.

Physical trauma to flesh by blunt force (crossbar) can be more serious, since there may be damage that you can’t see. Luckily our pubic bone and sit-bones (the bony part of our buttcheeks) generally prevent any unwanted blunt trauma inside the vagina, and crossbars, due to their nature, can’t get inside the vagina. This is useful information, because it means the damage is generally reserved for the fleshy part of your vulva. It seems your poor labia has taken the brunt of it.

If the cut is deep, won’t stop bleeding, is very painful or looks like there are flappy bits coming off it, or the labia itself is at risk of being separated somehow from other parts of your vulva, you need to go to the ER and get examined and maybe stitched up.

If the cut is shallow or small, you will probably get away with leaving it be with proper wound care principles applied (see below).

The genital area usually heals really quickly and well, without a lot of scarring, but it is very hard for me to determine without seeing the wound, what you should do. The labia are small and delicate, and there is a good chance that it is probably going to be just fine, and will heal over the course of several weeks. What you want to avoid is having permanent scarring, loss of sensation or function, or an infection that leads to either of the aforementioned.

If it is easy for you to stop in to a clinic and be examined, please do. If this is expensive or problematic for you, see if you can find a sexual health clinic that is free in your area. They look at vaginas all day long, and will be able to quickly tell if you need further assistance.

You know what wounds are like from falling off bikes all the other times in your life – wounds heal if you take care of them, so if it seems manageable, just manage it as you would any other cut.

Watch this TED video on the process of wound healing and what happens in the skin so you have some idea of what your wound is doing, and will know if something goes wrong. Keep in mind that your labial flesh is not the same as your regular skin, and the outer layer (epithelium) is slightly different to, say, your arm, but the principles are more or less the same.

  • Keep it clean – gently wash in just warm water once per day. Don’t rub it or irritate it in any way.
  • When you urinate, you may need to rinse with warm water afterwards to keep the acidic urine from stinging your labia for too long. It will hurt, every time, but there really isn’t heaps you can do about that except to minimise it. If you can pull your labia gently away from your stream of urine when you pee, try. Just try to keep the urine away from the cut as much as you can. A shower head will work very well for your purposes, and you could even circumvent a lot of stinging by actually peeing under the shower stream (annoying to do, but could be useful). Pat dry with a very soft cloth or towel.
  • Avoid tight underwear – keep everything as loose as possible. Skirts, dresses, old lady dungarees, MC Hammer pants, whatever you need.
  • If you are getting your period soon, this is going to be a problem for you pain-wise – no tampons or period cups, just because it will be painful to put in. Pads only, change frequently to avoid keeping blood around collecting bacteria. If you do get your period during this time, be super conscious of cleanliness and take washing or rinsing up to two or three times per day. Gently.
  • Your flesh stitches itself back together using proteins, and this process is slow and painstaking. You surely have experienced a cut re-opening because you moved your body the wrong way accidentally, or a scab fell off, or any number of things – you don’t want this happening, as it will slow healing. This means leaving the area as much alone as you can, not riding any bicycles (as if you could!), sitting carefully and just being very slow and gentle until you know how you can move without disturbing the healing.
  • Your inner labia are raw flesh, like your mouth, so you don’t need to apply any creams, lotions or potions to it – it will do it all by itself.
  • Keeping bad bacteria out is of paramount importance. You do NOT want an infection in your labia. You would benefit from keeping up with some ferments at this point just to keep your body flush with good bacteria, to make the chances of infection less in whatever way you can – this could mean a probiotic capsule (refrigerated only from a proper health food store or pharmacy), lots of homemade yoghurt, milk or water kefir, kombucha, homemade sauerkraut, or kimchi. Do not insert into the vagina, but just eat them – they permeate your system and come out the other end, and indirectly help to reduce bad bacteria and encourage the good. It’s a small preventative measure.

If you see any signs of infection (your labia becomes swollen, hot, painful), you need to see someone ASAP.

You need to be the judge of this, since I can’t see, so use this as a guide only, and make a decision based on the wound. It is often better to be safe than sorry, particularly where your vagina is concerned, so if it’s no big deal, see someone and get checked.

Write back anytime.

Warmest regards,
Aunt Vadge