Aunt Vadge: I have a perineal sore – is it an STI?

Dear Aunt Vadge,

I noticed pain in my perineum about a week ago. At first I thought it was a rash from wiping, but then I realized it was actually cut or torn. I did not have any painful intercourse prior.

It seems to be getting worse now and not better, and feels a little swollen now as well. I’m completely leaving the area alone but feel no improvement. I have a doctor’s appointment scheduled in a week, but don’t know if I can or should wait that long.

How do I know this is a tear and not an STD? And how can I get relief?


Dear Torn,

When cuts or sores appear for seemingly no reason, it is usually because the cause of the outer wound is inside of us. Sounds decidedly metaphysical, and although it might be the physical manifestation of a deep emotional wound, that is unlikely: there does appear to be another reason. This happens frequently with infections, particularly viruses. Viruses live in our bloodstream, whereas bacteria live locally in colonies. It could be either, or neither.

The perineum is the area between the anus and the vaginal opening, and unless physical damage has been done by surgery, sex, or sometimes bowel dysfunction (Crohn’s disease in particular), the cause remains – in your case – a mystery worthy of further investigations.

It would be advisable to get to your doctor – or another doctor if you are unable to make an appointment sooner – to get examined before the week is up. This is because if it is a sexually transmitted infection, your cut may heal up, making figuring out what it is harder. You may also be able to get medication to arrest the infection and save yourself some pain and suffering. You cannot fix an STI yourself, particularly if you have no idea which one it might be.

If it is not an STI, you are going to need to sit down with your doctor regardless and establish the cause with more in-depth questioning. It is completely abnormal to have a sore appear on your perineum for no observable reason, so you are right to get to the doctor as soon as possible no matter what.

In the meantime, be gentle, keep the area clean, don’t have sex, and don’t fiddle! Wear loose-fitting cotton underwear, don’t use perfumed or allergenic soaps, use non-perfumed, uncoloured toilet paper, avoid tampons if possible, and keep your eye out for any other developing symptoms.

You may benefit from keeping the area a little bit moist and protected with some paw paw ointment, Vaseline, or a vagina and vulva-friendly cuts cream.

Keep track of your signs and symptoms by writing them down as they happen – dates, times, size, activities that may have contributed – so the doctor has all the information they need to treat you effectively. It may also be useful to have photographic evidence to track changes the way you might a mole or weight loss.

If your doctor doesn’t know what’s wrong, find another one. If you see many doctors without success, or get a firm diagnosis that is not treatable via usual methods, see your local, experienced naturopath for a more advanced treatment plan.

If the pain is becoming more severe, the wound starts to bleed or weep or becomes otherwise unbearable, don’t wait a minute longer and see a medical practitioner immediately. Your mysterious wound needs to be healed.

Good luck Torn.

Aunt Vadge

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