Perineal tear without childbirth: what to know

The perineum can split or become grazed after sexual activity, friction, a fall, direct impact, a procedure or severe skin irritation. A small surface split may sting during urination or intercourse. A deeper injury can cause ongoing bleeding, swelling, bruising, difficulty sitting, or trouble controlling gas or stool. The location can make healing slower because the area is exposed to moisture, movement and contact with urine or bowel movements.

A tear is different from ordinary soreness: there may be a visible gap, fresh blood, raw skin or pain that is worsening rather than settling. A clinician may inspect the wound and check nearby muscles, nerves and the anal opening.

Pause sex, tampon use and activities that pull on the area until the skin has healed or a clinician has advised otherwise. Rinse gently with lukewarm water, pat dry, and use clean breathable underwear. Avoid fragranced washes, antiseptics and rubbing. A wrapped cool pack can reduce swelling for short periods. Keep bowel movements soft with fluids and fibre, and avoid straining.

Arrange a medical assessment for a visible wound, continuing bleeding, significant pain or a tear that does not improve. Treatment may include wound care, pain relief, treatment for infection when present, or stitches for a deeper injury. Pelvic-floor rehabilitation can help if pain, muscle tightness or control problems continue; see [Postnatal Physiotherapy](/treatments/pelvic-floor-and-rehabilitation/postnatal-physiotherapy/) for related therapy information. [Perineal Repair](/treatments/pregnancy-and-birth-care/perineal-repair/) describes repair-focused care.

Seek urgent care for heavy or unstoppable bleeding, a deep or gaping wound, faintness, severe swelling, severe pain, inability to pass urine, or new loss of bowel control. Prompt review is also needed for fever, pus, spreading redness, bad-smelling discharge or pain that is rapidly increasing. These signs can indicate substantial injury or infection and should not be judged by the size of the visible split alone.

Ask: How deep is the tear? Does it involve muscle? What cleaning and pain-care routine is suitable? When can I resume sex, exercise and bowel movements without straining? What changes would suggest infection or wound separation? Would pelvic-floor therapy help if the area remains painful or tight?