Treating mystery vulvar or vaginal cuts and tears

If you are getting frequent cuts and tears from normal sexual activity, regular daily practices or for no reason at all, there are several main areas to look into first.

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.

To help your cuts heal faster, you can try a vulva and vagina-friendly cuts cream.

If you want to investigate your vaginal microbiome, get a comprehensive vaginal microbiome test at home, no doctor sign-off required. For interpretation, book in with My Vagina’s specialist practitioners.

+ Looking from the outside

Outside irritants or causes could include soaps, perfumes, douches, creams, underwear, laundry detergent, sex, tampons, and 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 change inside our body causing symptoms. Something is interrupting the body functions responsible for keeping our skin strong, flexible, and robust, for example, a yeast infection, oestrogen deficiency or a nutrient deficiency.

Mystery cuts and tears – what could it be?

Atrophic vaginitis – low oestrogen

A dry, easily-torn vagina or vulva may be the result of lower oestrogen levels that come with ageing (nearing, during or after menopause), breastfeeding, oestrogen blocking drugs or low functioning ovaries.

Low oestrogen can result in thinning and poorly functioning vaginal tissue, known as atrophic vaginitis. Atrophic vaginitis leaves you open to easy tearing and cuts, along with irritation, dryness and itching, because the tissue is fragile. Weak tissue also results in poor wound healing.

Treatments for atrophic vaginitis

Increasing vaginal oestrogen will usually solve the problem, but that requires usually a topical application which can be cream from your doctor or a specialised pessary, such as Fennelope.

If you are struggling with genitourinary symptoms of menopause (GSM), book in with our specialist practitioners for holistic advice.

Not incidentally, sexual activity, including masturbating, is a scientifically proven way to stay juicy with low oestrogen conditions.

Whole foods high in phyto-oestrogens can also be useful (100g tofu per day with 1 teaspoon of crushed linseeds may work for some people).

Infections

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.

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.

If you are not getting the results you are seeking, get a comprehensive microbiome test.

Latex irritation or condom allergy

Latex may cause irritation to the vaginal walls with or without latex allergy, resulting in an irritated vagina and easier tearing by dried-out condoms. A dry condom is the enemy of good sex, so 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 common, and can be caused by many things, even if they say hypoallergenic – soaps, perfumes, cosmetics, spermicides, pessaries, condoms, and menstrual products. Not everything agrees with all bodies.

Additionally, some medicines can also cause contact dermatitis – benzocaine, hormone creams, corticosteroids, topical antifungals, and antibiotics. Ask your doctor about taking a break from your medicine or switching it up and see if it helps.

Nutrient deficiencies

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

Nutrients are a big topic that may need a professional’s eye on it, so visit a qualified and experienced nutritionist, dietician or naturopath to establish your nutritional status and look at some strategies for improvement.

One important wound-healing factor is zinc. 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.

The list of nutrients we need each day is long, so get good advice if you’re not sure.

Lichen sclerosis (LS) or lichen planus (LP)

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. LS or LP may develop slowly, come and go, or worsen quickly in some women.

Lichenoid conditions can fuse 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 and holistic practitioner as soon as possible.

Genital psoriasis

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

Treatments for your vaginal and vulvar cuts and tears

If your cuts were a one-off, they will heal on their own and not return. When you’ve successfully treated the cause of your cuts, they should resolve and not return, but until then, they are likely to heal and then reappear.

Our naturopathic vulvar and vagina-friendly cuts cream supports healthy healing, but addressing the root cause is key.

You may prefer a holistic practitioner to help guide you through this, such as a My Vagina vulvovaginal specialist practitioner or functional medicine doctor.

What your naturopath will do

If you are suffering from ongoing tears that you are unable to successfully resolve, once you have been assessed and diagnosed by your doctor, you may prefer assessment and treatment from a natural medicine practitioner.

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 vaginal 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 intestines.

Treatments may therefore be many and varied, and range from diet changes to topical or oral herbal medicine.

What your doctor will do

Your doctor may try to speed up healing or prevent infection with antifungal creams or tablets, antivirals for herpes, oestrogen cream for low oestrogen, with topical steroids for dermatitis, psoriasis or lichenoid disorders.

You may be prescribed 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.