Treating mystery vulvar or vaginal cuts and tears

If you are getting frequent cuts and tears from normal sexual or daily practices that previously didn’t cause cuts or tears, or for no reason you can identify, you could be suffering low nutrient levels (resulting in poor skin structure) or be low in oestrogen (menopause or ovary conditions).

But, it could also be several other conditions that are less easy to identify and treat. Anytime your skin starts to break down, you have to look at the things that interrupt normal skin function. You look both from the outside and the inside.

+ Looking from the outside
Outside irritants or causes could include soaps, perfumes, douches, creams, underwear, laundry detergent, sex, tampons, masturbating, that have broken down the outer, protective layer of skin.

+ Looking from the inside
Then, there are cuts and tears that result from a breakdown in our body, that is causing outward symptoms. That is, something is interrupting the body functions responsible for keeping our skin strong, flexible, and robust.

Mystery cuts and tears – what else could it be?

     Atrophic vaginitis – low oestrogen

A dry, easily-torn vagina may be the result of lowered oestrogen levels that come with ageing (nearing, during or after menopause) or other low-oestrogen conditions. These include anything that affects your production of oestrogen, like ovarian cancers or other hormonal disturbances. This is called atrophic vaginitis – thinning of the vaginal epithelium (cells). This leaves you open to easy tearing ‘for no reason’. It also results in poor wound healing, as the interruption to skin integrity is broad. If you are still in your fertile years, get to the doc ASAP.

Oestrogen creams or other therapy (including food) administered by your doctor or discussed with your naturopath will easily resolve this problem and has demonstrated a good safety record. Do not self-prescribe – hormones need to be handled with care, particularly after menopause and in particular for those who are post-breast-cancer (see atrophic vaginitis article specially for you).

Not incidentally, sexual activity, including masturbating, is the best way to stay juicy with low oestrogen conditions. Whole foods high in phyto-oestrogens are also useful (try 100g tofu per day with 1 teaspoon of crushed linseeds may work for some women).

     Latex irritation or condom allergy

Latex may cause irritation to the vaginal walls with or without allergy, resulting in an irritated vagina and easier tearing by dried out condoms. Always use a good-quality water-based lubricant, and try latex-free condoms if you suspect you are having a reaction.

     Contact dermatitis

Contact dermatitis is actually quite common, and can be caused by many things – soaps, perfumes, cosmetics, spermicides, pessaries, condoms, and menstrual products. Additionally, some medicines can also cause contact dermatitis – benzocaine, hormone creams, corticosteroids, topical antifungals, and antibiotics. Stop what you are applying, go hypoallergenic, and see what happens.

     Nutrient deficiencies

If you are suffering regular fissures that won’t go away, it might be useful to do a dietary analysis and make sure you are getting everything your body needs to heal wounds, maintain tissue strength and flexibility, and defend against invaders.

This is a complex topic that will need a professional’s eye on it, so visit a qualified and experienced nutritionist or naturopath to establish your nutritional status and look at some strategies for improvement.

One such factor could be zinc deficiency, which is pretty common. Low zinc signs include white spots on your nails, lowered sense of taste and smell, getting sick often with colds and flu (poor immunity) and slow wound healing. Other vitamins involved in skin healing are vitamin A (retinol), omega-3 fatty acids, vitamin C, and calcium. You could also be low in protein, particularly if you are a vegan or vegetarian. You should be getting a fist-sized amount of protein at each meal, every day.


Yeast infections can be a risk factor particularly when antibiotics have been used, as first the yeast, then the antibiotics, disrupt the natural bacterial balance. Some yeast infections can actually ‘grow legs’, and while you may have a negative yeast test, you will respond to systemic antifungals.

This isn’t the only troublesome infection, however, as STIs can impact on your vaginal flesh and flora too. Herpes is a virus that causes sores to appear on and around the vagina, but is not the same as a cut or tear. Their presentation is different, but a minor outbreak may feel like a cut or tear if you haven’t looked very hard.

If you suspect you have an infection – you have unusual discharge, odour, pain, itching, sores or swelling – go and get tested. Treat the cause, and your cuts and tears will go away.

     Lichen sclerosus or lichen planus

LS is a type of autoimmune dermatitis affecting the vulva, which originally presents as an itchy vulva, and results in thickened vulvar tissue with cracks, fissures, tearing and bleeding. This condition may develop slowly, come and go, or worsen quickly in some women. It can fuse the vulva together completely, resulting in the surgical removal of the vulva, among other serious impacts.

LS is a cause of fissures. If you suspect you have something more going on and could be developing LS, check out our LS page and make an appointment with your doctor as soon as possible. There are ways to help save your vulva.

     Genital psoriasis

While genital psoriasis usually presents as red scaly skin, it can dry out to the point where it causes fissuring and cracks. Check out the genital psoriasis page and see if your symptoms match.

Vaginal fissures in children

What a health professional can do for your mystery cuts and tears

     What your naturopath will do

A naturopath will take a longer appointment to look at what you eat, your sexual practices, hormones, and any other elements that may be contributing to your fissures. You could have signs of hormonal imbalances, deficiencies in your diet, or other, more complex problems that could include your thyroid, adrenal glands, or even your intestines. Treatments may therefore be many and varied, and range from diet changes to topical or topical or oral herbal medicine.

     What your doctor will do

The medical way of dealing with vaginal cuts and tears – outside of those that require surgical or other serious medical intervention – is, like naturopathy, to let them heal by themselves. Your doctor may – to speed up healing or prevent infection – prescribe an antifungal cream or tablets, antivirals for herpes, oestrogen cream for low oestrogen, with topical steroids for dermatitis, psoriasis or lichenoid disorders usually prescribed. You may get topical anaesthetic and antibiotic creams or gels.

Surgery may be an option if it is recurrent, called a perineoplasty. The torn skin is cut out completely and replaced by vaginal skin to cover the gap, then  stitched up. It is not always successful, and only your physician can say if this is recommended or not, and why this option is preferred. Fistulas will require specific treatment, usually surgical.

Think your fissure is different? Ask Aunt Vadge.