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Hi Aunt Vadge,
The first couple of times I had intercourse, I didn’t get a fissure. A couple of times later I got a fissure on my posterior fourchette. It heals in between every time I have sex, but then happens again every time. Do I need stitches, or what do I need to do differently?
Yours,
Stitched Up
Age 18, USA
Dear Stitched Up,
No, you almost certainly don’t need stitches – a posterior fourchette fissure that heals fully between times and only opens with sex is a recurrent friction tear, not a wound that needs sewing.
And you’ve given me the key clue yourself: the first few times you had sex it didn’t happen, then it started, which means it’s about how it’s happening now, not a fixed flaw in you.
That spot, the posterior fourchette at the bottom of the vaginal opening, is the most common place to tear, and it splits when penetration outpaces how aroused and lubricated you are, or when the angle or size puts extra stretch right there.
So the things to do differently: make sure you’re properly, unhurriedly aroused before any penetration (the tissue plumps and stretches far better when you’re really turned on), use plenty of lube every single time and reapply it, go slower and start shallow, and choose positions where you control the depth and angle (you on top) so you can keep pressure off that spot.
Give any fresh tear a few days to fully heal before sex again, rather than reopening it.
If, once you’re doing all that, it still tears every time, it’s worth a doctor or vulval clinic checking for a fragile-tissue cause – a recurrent fissure can occasionally be linked to a skin condition or, in some, the contraceptive pill thinning the tissue – and a pelvic-floor physiotherapist helps if you’ve started tensing up in anticipation.
But for most people at your stage it’s arousal, lube and pace, and that fixes it without a single stitch.
For soothing and healing minor cuts and tears, here’s how to deal with cuts and tears from fingering and rough sex.
Warmest regards,
Aunt Vadge
This is general information, not a substitute for personalised medical advice.
