Something else? Ask Aunt Vadge – bottom left of your screen!
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 realised it was actually cut or torn. I hadn’t had any painful intercourse beforehand.
It seems to be getting worse rather than better, and feels a little swollen now too. I’m completely leaving it alone but see no improvement. I have a doctor’s appointment in a week, but I don’t know if I can or should wait that long.
How do I know this is a tear and not an STI? And how can I get relief?
Yours,
Torn
Dear Torn,
Don’t wait the full week – please try to be seen in the next day or two instead. A perineal sore that turned up without any injury, and is getting worse and swollen rather than settling, is exactly the kind of thing that’s worth a doctor’s eyes on it sooner rather than later.
To your main question – how do you tell a tear from an STI? You mostly can’t, by looking, and that’s the whole reason to go promptly. When a sore appears for no obvious reason, an infection is often behind it – a virus like herpes can show up as a plain split or sore rather than the textbook blisters, and that’s the sort of thing a swab can identify. The catch is that a swab is far more reliable while the sore is still active, so if you let it heal first, you can lose the chance to find out what it was. Going now gives you the best shot at a clear answer, and possibly medication to take the edge off and speed things up.
If it turns out not to be an STI, you’ll still want that conversation, because a sore arriving on the perineum out of nowhere isn’t something to shrug off. Occasionally it’s down to something like a bowel condition (Crohn’s disease can affect the skin down there), so it’s worth getting to the bottom of either way.
While you’re waiting for the appointment, be gentle and keep it simple. Wash with plain warm water only, no perfumed or harsh soaps, use plain undyed toilet paper, wear loose cotton underwear, skip tampons and sex, and resist the urge to keep checking and prodding it. A thin smear of plain Vaseline or pawpaw ointment can keep the skin comfortable and protected. Our guide on caring for a simple tear has more.
Keep a few notes as things change – dates, size, how it feels, anything that seemed to set it off – and a photo or two really helps the doctor, the way you might track a mole. It saves you describing it from memory once you’re in the room.
Go sooner still – same day, or to an urgent care – if the pain climbs sharply, it starts bleeding or weeping, you spot more sores appearing, or you feel feverish and unwell. Once you’ve got a diagnosis and if the root cause needs untangling, you’re welcome to book an appointment with us for the follow-up side of things.
You’re doing the right thing by taking it seriously. Get seen, and you’ll have answers soon.
Sincerely,
Aunt Vadge
This is general information, not a substitute for personalised medical advice.
