Pain in the perineum is a fairly common symptom that can occur in both females and men, regardless of the age category. In the vast majority of cases, a similar symptom indicates the course of a disease of the genitourinary system. From this it follows that the sources for both sexes can be both general and individual.
Most often, in addition to pain, the clinical picture is made up of such manifestations as discomfort while walking or during prolonged sitting, itching and burning in the problem area, as well as impaired urination.
The clinician will be able to make the correct diagnosis and find out the cause only after studying the results of laboratory and instrumental examinations. Treatment is dictated by the predisposing factor, but is often based on conservative methods.
Etiology
Most often, the causes of pain in the perineum are the course of a disease that affects the genitourinary system, which in men and women has a different structure, therefore, the sources of such a symptom will be divided into several groups.
- prolonged effect on the body of low temperatures;
- injury or injury to the perineum;
- diseases that affect the skin, in which are formed, go;
- pathology of the gastrointestinal tract, in particular, the formation of hemorrhoids of external and internal localization, and, as well as;
- chronic pelvic pain syndrome;
- irrational nutrition;
- traumatic sexual contact;
- some STDs, for example, or;
- previous surgical interventions on the organs of the genitourinary system;
- malignant neoplasms or cancer metastasis;
- irrational nutrition;
Pain in the perineum in men can also be caused by such predisposing factors:
- acute or chronic form;
- the course of the inflammatory process in the urethra, testicles or seed tubercle;
- abscess or oncology of the prostate;
- infringement of the genital nerve;
- and prostate cysts;
- cystic neoplasms in the testicle, epididymis or spermatic cord;
- presence or ;
- trauma to the scrotum or penis;
- dilatation of the veins of the testicle, which is also called.
Pain in the perineum in women is due to such reasons:
- inflammation of the fallopian tubes or vagina;
- gap - while pain will be noted not only when walking, but also during or after sex, or in cases of prolonged sitting. Pain can be localized both on the left and on the right, which indicates the affected ovary;
- oncological damage to the uterus;
- gynecological diseases that violate the normal microflora of the vagina;
- perineum.
In addition, a similar symptom in females can occur during menstruation or during childbearing.
Separately, it is worth noting about the pain in the perineum during pregnancy. By the time of occurrence, such a symptom appears:
- before childbirth- soreness indicates that the woman will become a mother in the next few days, and the baby has come close to the birth canal. Although pain in the perineum before childbirth is not normal, it is not a cause for concern;
- directly during pregnancy– often occurs around 35 weeks prenatal development fetus, since starting from this period, the female body is preparing for labor, namely, the hip bones are moving apart. In addition, a similar symptom is expressed if it compresses the sciatic nerve. However, not in all situations, such a symptom is considered normal - pain in the perineum in the early stages acts as an alarm signal indicating the likelihood of a miscarriage;
- after the baby is born- is also considered a normal, but unpleasant consequence of labor activity. Very often childbirth leads to various injuries, ruptures and other phenomena. Often, pain in the perineum after childbirth goes away on its own a few days after the birth of the baby.
Classification
Depending on the predisposing factor, pain in the perineum in men and women is divided into:
- primary- is formed against the background of various neurological disorders or direct trauma to this zone;
- secondary- is such if it radiates when others are affected internal organs such as the prostate, uterus, or bladder.
By origin, a similar symptom happens:
- visceral- the main cause is irritation of nerve endings, localized directly in the organs of the genitourinary system;
- psychogenic- often occurs in the absence of the course of a particular ailment, in persons with certain character traits or as a response of the body to a stressful situation;
- neurogenic- develops with damage to the nerve tissues in this area.
Depending on the nature of the manifestation, the following types of pain syndrome exist:
- pulling pain in the perineum - may indicate the course of the oncological process;
- arching pain - very often experienced by women during a leak. Bursting type soreness is also present shortly before childbirth;
- sharp pain in the perineum - caused by urolithiasis and cystitis, bruises and hematomas;
- shooting pain;
- dull pain in the perineum - often develops due to inflammation of the organs located in this area;
- aching pain - most often occurs against the background of urological problems, which means that it is typical for men. In women, aching pain is associated with stretching or swelling of the birth canal.
According to the duration of the expression, they distinguish:
- acute pain in the perineum - worries a person for several minutes or hours, but not more than a day;
- chronic pain in the perineum - is such if it is mild and has been present for three or more months.
Symptoms
The clinical picture that complements the pain in the perineum in men and women will differ depending on which disease caused the onset of the main symptom. From this it follows that the symptoms will be individual.
Nevertheless, it is worth highlighting the most common symptoms:
- the spread of pain in the lumbar region, lower abdomen and pelvic region;
- frequent and painful urge to urinate, including at night;
- sensation of pain and burning during emptying of the bladder;
- periodic or persistent pathological discharge from the vagina or urethra, which may have a specific color and smell;
- the presence of impurities of pus or blood in urine or semen;
- false urge to defecate;
- feeling of a foreign object in the rectum;
- increase in body temperature;
- enlargement of the affected testicle;
- increased pain intensity during sex or during physical activity;
- significant redness of the penis or labia;
- feeling of incomplete emptying of the bladder.
Diagnostics
Only a clinician can determine the cause of the pain in the perineum. For an initial consultation, you should go to, who, after conducting an initial diagnosis, can refer the patient for an additional examination to such specialists:
- obstetrician-gynecologist - if there is pain in the perineum during pregnancy;
- - in rare cases, the appearance of a similar symptom in children.
Such doctors will prescribe specific laboratory and instrumental examinations, but the basis of the primary diagnosis will be:
- studying the medical history and life history of the patient - to detect a disease that could lead to pain of a different nature in the perineal region;
- a thorough physical examination, namely gynecological and urological, digital examination of the rectum and palpation of the lower abdomen. Often this will indicate which side the affected ovary or testicle is on;
- a detailed survey of the patient - to determine the nature of pain, the presence and severity of additional symptoms;
- general clinical analysis of blood and urine;
- swab sampling for flora from the urethra and vagina;
- blood biochemistry;
- blood test for hormones and tumor markers;
- microscopic examination of feces;
- radiography and ultrasound of the peritoneum or pelvic organs;
- colonoscopy and sigmoidoscopy;
- irrigoscopy and gastroscopy;
- cystography and FGDS;
- CT and MRI.
It must be remembered that the list of diagnostic procedures can be expanded depending on which specialist the patient will be referred to.
Treatment
For the relief of cutting, stabbing, bursting and other types of pain in the perineal area, conservative methods are used, including:
- taking antibacterial and anti-inflammatory drugs, using rectal suppositories and local ointments;
- application of traditional medicine recipes;
- physiotherapeutic procedures, in particular microwave, laser therapy and magnetotherapy;
- diet therapy - to avoid the development of complications from certain diseases.
Almost all therapeutic methods are prescribed by the attending physician on an individual basis for each patient. The only exception is folk remedies, which involve the implementation of sitz baths with the addition of:
- chamomile and calendula;
- potassium permanganate and soda;
- oak and yarrow bark;
- flax seeds and horse chestnut;
- St. John's wort and elderberry;
- lingonberry leaves and hops.
The main indications for surgical intervention are the detection of oncological formations or cystic tumors, urolithiasis disease and failure of conservative therapy.
Pain in the perineum during pregnancy requires careful monitoring by the attending physician when using medications and folk recipes. The operation, if necessary, is carried out only after the baby is born.
Prevention and prognosis
In order for people not to have problems with pain in the perineum, it is recommended:
- be active and healthy lifestyle life;
- avoid hypothermia;
- engage in protected sex - to prevent STDs;
- eat right and balanced;
- if possible, avoid perineal injuries and stressful situations;
Under the perineum, perineum, in the narrow sense of the word, is meant the area of tissue between the anterior edge of the anus and the posterior edge of the external genitalia or parts (the root of the scrotum in men, the posterior edge of the genital slit in women).
In topographic anatomy, the perineum is called the exit area of the small pelvis. The area is occupied by the external genital organs and the anal part of the rectum. The crotch area has a diamond shape; in front, it extends to the lower edge of the pubic symphysis, behind - to the top of the coccyx and is limited on the sides by the pubic and ischial bones and sacrotuberous ligaments, ligg. sacrotuberalia, separated from the thigh by a femoral-perineal fold.
Perineal region, regio perinealis. forms the bottom of the pelvis, thereby closing the exit from the latter, and is divided into the anterior, smaller, urogenital region, regio urogenitalis, and the posterior, large, anal region, regio analis. The exit from the cavity of the small pelvis is closed by muscles, fascia, fat and skin, which are located differently in each part of the perineum. A slightly convex anterior line connecting the right and left ischial tuberosities is the border of these two areas. Located along the mid-sagittal line, the skin fold, suture, raphe, perineum, as it were, divides the skin of this area into the right and left halves. In the urogenital region, regio urogenitalis, are the external genitalia, the urethra and the urogenital diaphragm, diaphragma urogenitale. The urethra passes through the urogenital diaphragm in men, and the urethra and vagina in women.
What diseases cause pain in the perineum
The main causes of pain in the perineum:1. Pain or any discomfort in the perineum almost always indicates problems with the prostate gland, most often chronic prostatitis or seminal vesicles. Painful irritations from the prostate gland and the posterior urethra are transmitted through the sacral nerves. Localization of pain - in the perineum, rectum.
When such symptoms appear, you should definitely contact and be examined by a urologist.
2. Pain in the perineum after natural childbirth is likely to worsen in cases where the perineum has been torn or cut during an episiotomy and then sutured.
3. In acute urethritis, pains are sharp and painful, in chronic they are less strong and are perceived as a burning sensation. The pain may not be associated with the act of urination and may be permanent - this usually happens with colliculitis (i.e., inflammation of the seminal tubercle in the posterior urethra). Pain in diseases of this part of the urethra is localized in the perineum.
4. Pain in the perineum is characteristic of diseases of the prostate gland. In acute prostatitis, the pains are sharp, pulsating, and radiate to the anus, sacrum, and glans penis. In chronic prostatitis, the pain is not intense, long-lasting and has a pulling character.
5. Abscesses (abscesses) occur more often in isolation in one lobe of the prostate gland, while pain is most disturbing on the affected side. Almost always the chair is delayed, the gases do not go away, urination is difficult. In the stage of active abscess formation, there are severe pains in the perineum, radiating to the sacrum, inner thighs, rectum with high body temperature.
6. Inflammation of the bulbous urethral gland (couperitis) most often accompanies urethritis of any origin, since the infection enters these glands directly from the urethra. If the outflow of secretion from the bulbous urethral gland during its inflammation is not disturbed, then the patient feels moderate pain in the perineum, especially in the sitting position and during the act of defecation.
If the outflow of the secret is difficult, suppuration of the gland occurs, the pain in the perineum and at the root of the penis increases sharply, the body temperature rises, and there may be chills.
7. Traumatic injuries of the urethra and prostate:
- Closed injuries of the urethra occur most often as a result of the direct impact of a traumatic force on the urethra (fracture of the pelvic bones, falling on the perineum, forced insertion of a metal catheter, bougie or cystoscope, birth trauma, prostate surgery, etc.). Distinguish bruise, incomplete rupture, or tear, and crushing of the urethra. The main symptoms are shock, dull pain in the perineum, scrotum, sharp pain in the urethra, urethrorrhagia, acute urinary retention, frequent ineffectual urge to urinate, overdistension of the bladder, hematoma and urinary streaks on the perineum, scrotum, thighs.
- Open injuries of the urethra are divided into isolated and combined (gunshot, stab, cut, bruised, torn, bitten). Stab wounds are localized in the perineum, and the penis is also damaged. Incised wounds can be complete or incomplete, and bite wounds damage mainly the spongy part of the urethra and the penis. These injuries are manifested by acute urinary retention, frequent urination, urethrorrhagia, pain in the perineum and lower abdomen, enlargement of the bladder, urine discharge from the wound during urination.
- Among the closed injuries of the prostate gland and seminal vesicles, bruises and ruptures are distinguished, which often occur with fractures of the ischial bones, a strong blow to the perineum, a fall on a hard object, as well as forced or incorrect introduction of metal catheters, bougie, cystoscopes into the urethra. Clinically, this type of injury is manifested by pain in the lower abdomen, in the anus and perineum, frequent painful urination, micro- or macrohematuria, hemospermia.
- Among the open injuries of the prostate gland and seminal vesicles, bruises, tangential, blind and penetrating wounds are distinguished. The most common are gunshot and stab wounds, usually combined. Patients complain of pain in the perineum, urethrorrhagia and dysuria. There may be tamponade of the bladder with blood clots, urinary infiltration, excretion of urine through the rectum or perineum. The diagnosis is established on the basis of anamnesis, clinical picture, results of rectal examination, urethrography. Treatment consists in the primary surgical treatment of the wound, stopping bleeding, removing foreign bodies and hematomas.
8. Perineal tears during childbirth
Scar tissue resulting from tears or cuts in the perineum during childbirth. Almost all women who have undergone such an intervention experience pain in the perineum during penetration and during intercourse for about three more months.
9. Infringement of the pudendal nerve, which can occur suddenly or develop over time. Long sitting, cycling. repetitive movements and leg exercises can lead to pudendal nerve entrapment.
Some people have mostly rectal pain sometimes with bowel problems. In others, pain in the perineum or genitals predominates. Symptoms may include stabbing, cramping, or burning pain, tingling, numbness, or tenderness. Usually the symptoms are worse when sitting and better when standing or lying down. There may be a feeling that a person is sitting on a tubercle.
10. With prostate cancer, pain in the perineum is observed, which can radiate to the sacrum, lower back and thighs.
Which doctors to contact if there is pain in the perineum
Obstetrician-gynecologistProctologist
Urologist
Oncologist
Pain in the perineal region in males can often occur due to the fact that they have a predisposition to inflammatory pathologies of the urinary systems, such as inflammation of the seminal sacs, urethritis, various diseases of the prostate gland, and so on. Sometimes the main causes of pain sensation, itchy burning of the male perineum are factors such as hypothermia, sexually transmitted diseases, as well as complicated forms of cystitis and urethritis. Pain in the perineum can be aching, sharp, itchy, pulling, twitching, throbbing.
The appearance of sharp pains in the perineum
Lower abdominal painAcute, sharp pains in the perineal region in males are often associated with inflammation of the prostate region. This pathology is accompanied by negative symptoms. Pain can be felt in the penis, anus, its ring, sacrum. Pathologies of the urethral canals are common causes of a sharp pain sensation. When a man gets rid of the fluid that accumulates in the urethra, this greatly increases the pain, itches.
Also, a sharp pain in the perineum in men can be one of the symptoms of purulent formation in the prostate area. It can give through the rectum, the area of the sacrum. Such a disease is characterized by its unilateral location, that is, pain from the side where the purulent focus was localized. Men supplement this "bouquet" with a violation of the rejection of feces, as well as urinary excretion. The temperature is noticeably increased, which causes a negative regression of the central nervous system.
Severe burning sensation in the perineum in men may be accompanied by the last stage of prostate cancer. In this case, only narcotic drugs can anesthetize the inflamed focus. One of the causes of sudden onset of pain can be pinching of the genital nerves. Only during sleep can a man get rid of pain for a while. The latter tend to intensify when walking, lying down, and sitting. When any of the nerves is pinched, there is a feeling of dumbness in the thigh.
A strong sharp pain point of the male perineum occurs with any injury:
Pain in the perineum - hematoma formations;
- severe bruises;
- gunshot wounds;
- subcutaneous muscle ruptures;
- stab wounds.
Since multiple nerve endings are concentrated in the perineal region in men, with different kind traumatic bruises, they may lose consciousness from excessive pain in the groin area.
Aching and pulling pain
Aching pain in the perineum in sick men can appear in the case of chronic urethritis, as well as inflammation of the prostate gland (most likely chronic), colliculitis, and other pathologies that negatively affect male sexual function and the reproductive system.
Often, men tend to describe this sensation as itchy. In this case, the pains are not so strong, but tend to be long-term, in some cases - eternal. Prolonged itching in the perineum in men and general discomfort is aggravated when men take a hygienic toilet. In such a situation, this is due to the fact that inflammatory processes in the region of the urethral-bulb glands, that is, cooperitis, are possible. The disease has the property of taking an adventure from inflammation of the urethral canals. During the pathology of couperitis, suppuration of the area may increase inflammatory processes.
It is also necessary to remember that pathologies of the urinary tract in men are not necessarily accompanied by pain, itching of the perineum.
To this list, urologists add factors:
- various pathologies of the rectum: fissure, tumor, paraproctitis, hemorrhoidal manifestations;
- neuralgic pathology, which includes trauma to the nerve trunk, violation of the coccygeal-sacral parts of the vertebral parts;
- a spike in the pelvic areas that appeared after surgical interventions or inflammatory processes;
- psychosomatic pain;
- muscle spasm;
- various pathologies of the hip joint.
Male individuals associate pain in the perineum with various inflammatory processes in the prostate, inguinal region. Such pathologies are accompanied by a strong formation of pain. Also one of the many reasons for the manifestation of uncomfortable sensations is, which can manifest itself in both males and females. Such syndromes are accompanied by pain under the navel, extending to the perineum. Such patients are prescribed therapy, which is aimed at ensuring that the patient stops itching.
Itching in the perineum causes
When pain is accompanied by itching in males, there can be many reasons, but various fungal diseases, often such as thrush, are considered to be the main ones. Feelings of itching, burning sensations may appear during the activation of genital herpes. The same unpleasant sensation can occur during the development of various allergic diseases, cirrhosis, hepatitis, diabetes mellitus, diseases of the urethra.
Itchy under the testicles Burning and itching sensations are caused by almost everything, even cheap underwear that contains synthetic materials. Wearing such underwear tends to cause allergic reactions, create artificial greenhouse effects. With the help of bacterial pathogens of various dangerous infections that wake up during the activation of the greenhouse effect, a large number of diseases appear. Therefore, synthetic underwear must be excluded from your wardrobe, so as not to invite trouble to your reproductive system, and also not to cause pelvic disease.
Pain with the transition of pain in the groin
Various pathogenesis of the perineum tend to radiate to the inguinal region. There are a large number of factors that cause men to reveal all the negative symptoms in themselves. Often, such a pain sensation appears in males, who, to the best of their professionalism, are associated with systematic physical overexertion. This is what caused the fact that inguinal and perineal pains disturb the global number of athletes, bodybuilders of different categories.
The most common manifestations of such symptoms can be determined:
Discomfort in the groin - The formation of hernias (prolapse from the peritoneum under the skin of the organ) is formed due to weakening of the abdominal tissue due to excessive physical activity. In order to diagnose this disease, no serious studies and analyzes are often carried out; a hernia is detected during a routine examination of a person. If the hernia is hidden far under the tissues, a person is assigned to palpation. One of the traditional diagnostic methods for detecting hernias is an ordinary cough. When a person coughs, a pulling heaviness is felt under the navel.
- One of the common causes of pain in the perineal and groin areas is the inflammatory process of the pelvic organs. Such pains manifest themselves due to an infectious increase in the body. Affecting pathogens, the growth of lymph nodes begins, causing wild pulling pains.
- Unpleasant sensations in the groin and perineum in males are manifested due to the formation of kidney stones, especially when the stones are extremely low or already penetrate the urethra.
- Pain may appear with osteochondrosis of the vertebra lumbar. When a person discovers that he has such a pathology, he discovers that in case of complication, the disc part of the vertebra can compress one of the many nerve endings. Therefore, sharp and sharp pain sensations are formed in the groin area.
In the event that a burning sensation, pain in the perineum makes itself felt when the body rejects fluid from the urethra, there is an urgent need to test for a prostate-specific antigen. In this way, it is possible to check the presence of inflammatory processes in the body, indicating pathologies associated with disorders of the prostate glands, urethral canals, and colliculitis.
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Introduction
Since the perineum is the location of the external genital organs, the outlet of the urethra (urethra) and the anus of the rectum, pain in this area is associated with diseases or injuries of these organs. specific reasons pain in the perineum enough.Causes
Pain in the perineum can be caused by the following diseases and conditions:- sharp or chronic prostatitis;
- urethritis (inflammation of the urethra);
- cooperitis (inflammation of the bulbous urethral gland);
- colliculitis (inflammation of the seminal tubercle in men);
- orchitis (inflammation of the testicles);
- vaginitis (colpitis) - inflammation of the vagina;
- bartholinitis - inflammation of the glands of the vestibule of the vagina;
- perineal injury (including trauma during childbirth);
- pregnancy;
- infringement of the genital (shady) nerve;
- prostate abscess;
- prostate cancer;
- skin diseases: boils, warts, papillomas;
- diseases of the rectum: hemorrhoids, rectal fissures, proctitis (inflammation of the rectum), paraproctitis (inflammation of the tissue surrounding the rectum);
- chronic pelvic pain syndrome.
The nature of pain in the perineum in various diseases
Sharp pains
Sharp, sharp pains in the perineum in men are most often associated with acute prostatitis. With this disease, pain can be given to the sacrum, to the head of the penis, to the anus. Acute urethritis also causes severe, sharp pain. This pain is aggravated by urination. Sudden sharp pain in the perineum is characteristic of infringement of the pudendal nerve. Such pain is slightly relieved if the patient is standing still. When walking, as well as in sitting and lying positions, the pain intensifies. A pinched nerve can cause a feeling of numbness in the inner thigh area.
In some cases, there may be sharp pain in the perineum in pregnant women (see below).
Strong, sharp pain occurs with any injury to the perineum:
- subcutaneous muscle ruptures;
- gunshot wounds or wounds inflicted by cold weapons.
Drawing, aching pains
Pain of this nature occurs in the perineum with chronic prostatitis, chronic urethritis, colliculitis (inflammation of the seminal tubercle in men). Often the pain in these diseases is described by patients as a burning sensation in the perineum. These pains, although not too intense, are long or even constant.Constant aching pain in the perineum, aggravated by defecation and in a sitting position, is accompanied by cooperitis (inflammation of the bulbous urethral gland in men). This disease is usually a complication of urethritis. Pain in cooperitis can increase dramatically if suppuration of the gland develops.
Aching in nature can also be postpartum pain in the perineum associated with swelling and stretching of the birth canal.
Stitching pains
Pain in the perineum of a stabbing nature is more often observed in women, for example, with vaginitis (colpitis) - inflammation of the vaginal mucosa. These pains are combined with pains in the vagina itself, and with copious discharge from it.Stitching, rather intense pain in the perineum may be experienced by pregnant women shortly before childbirth.
Pain in the perineum in men
In men, pain in the perineum is most often associated with diseases of the prostate gland - prostatitis, abscess, malignant tumor. They are accompanied by pain and inflammation of the seminal tubercle (colliculitis), as well as inflammation of the bulbous urethral gland (couperitis). Pain in the perineal region may be accompanied by the mysterious chronic pelvic pain syndrome. This syndrome can occur in both men and women. The patient experiences pain in the lower abdomen, radiating to the perineum, but no signs of any disease can be identified. Such patients are given symptomatic treatment.
Pain in the perineum in women
In addition to diseases of the vagina and chronic pelvic pain syndrome, discomfort and pain in the perineal region are often observed in women during pregnancy.During pregnancy
Pain in the perineum most often occurs in pregnant women after the 35th week of pregnancy, when the growing fetus begins to sink down, while putting pressure on all surrounding tissues (nerves, muscles, ligaments). It is with a sprain that a woman experiences stabbing pains in the perineum. If such pain occurs in early pregnancy, you need to be wary of a possible miscarriage.
In the process of preparing the female body for childbirth, the pelvic bones move apart, which can also cause pain in the perineum.
Sometimes the fetus in the womb assumes such a position that it compresses a nearby nerve (for example, the sciatic nerve). At the same time, the woman experiences a sharp pain that makes all movements difficult, and does not subside even at rest. Unfortunately, in this case, doctors cannot provide any help: the pregnant woman is forced to endure pain and wait for the position of the fetus to change.
Itching and pain, described as burning, can occur in the perineum with various allergic reactions, diabetes mellitus, liver diseases (hepatitis, cirrhosis, etc.), and diseases of the genitourinary tract.
Such a seemingly insignificant factor as wearing synthetic underwear can cause excruciating itching and burning in the perineum. Except allergic reaction skin, synthetic underwear due to the "greenhouse effect" creates favorable conditions in the perineum for the development of all kinds of inflammatory and infectious diseases.
When urinating
Pain and burning in the perineum when urinating - symptom characteristic of prostatitis, colliculitis, urethritis. Such pain is experienced when urinating a woman in the postpartum period, if during childbirth there was a rupture of the perineum, and stitches were applied.When walking
Pain in the perineum that occurs or increases when walking is felt by people with coccyx injuries (bruises, fractures). In men, difficulty walking, combined with pain in the perineum, occurs with inflammation of the testicles (orchitis) or their appendages (epididymitis), with dropsy of the testicles.During and after sex
In men, pain after sex in the perineum and testicles can be observed with varicocele (varicose veins of the testicle and spermatic cord). Such pains are not too intense, decrease when walking and increase when standing still. The duration of pain is a few minutes, a maximum of several hours. Then it spontaneously disappears.Prostatitis can sometimes cause pain in the perineum during intercourse.
In women, the cause of pain in the perineum during and after sex is most often bartholinitis - inflammation of the Bartholin glands. These glands are located in the vestibule of the vagina and produce its lubrication. Pain with bartholinitis is pulsating in nature, and lasts several hours after intercourse, then subsides.
Men with complaints of pain in the perineum should initially consult a urologist or proctologist. You may need the help of a dermatologist or oncologist.
Which doctor should I contact for pain in the perineum?
Pain in the perineum is provoked by various tissue and organ structures located in the pelvis and the skin of this area of the body. And since in men and women in the pelvis there are a number of identical organs (intestines, bladder, etc.), as well as a number of completely different genital organs, the causes of pain in the perineum can be both common diseases for men and women, and specific pathologies inherent in each sex separately. For example, diseases of the intestines, bladder, urethra, as well as boils or ulcers on the skin can provoke pain in the perineum in both men and women. But diseases of the prostate gland, testicle, epididymis, bulbous urethral gland, seminal tubercle can provoke pain in the perineum only in men, since women do not have such organs. Accordingly, diseases of the Bartholin gland and the vagina can provoke pain in the perineum only in women, since these organs are exclusively female, men do not have them. Given this state of affairs, we will consider separately:1. In what cases should men and women with pain in the perineum go to the same doctors, since the pain syndrome is caused by the pathology of the organs that both sexes have.
2. In what cases do women and men need to contact doctors of different specialties for pain in the perineum, since the pain syndrome is caused by the pathology of organs specific to the male or female.
So, women and men should contact doctors of the same specialty if pain in the perineum, together with other symptoms, indicates urethritis, perineal trauma, infringement of the pudendal nerve, boils, papillomas or condylomas in the perineum, hemorrhoids, rectal fissures, proctitis, paraproctitis, allergic reactions, coccyx injuries.
If an injury has been inflicted in the perineal region (bruise, blow, injury, tears, etc.), then there is a sharp and very severe pain. In such a situation, you should immediately call an ambulance and be hospitalized in the hospital, as if the perineum is injured, the various bodies and fabric is so strong that without qualified medical care the person will die.
If pain in the perineum periodically occurs in a person some time after the injury (including after childbirth), then it is recommended to contact surgeon (make an appointment) And Rehabilitologist (sign up) so that they jointly develop a plan for the necessary rehabilitation therapy.
If a woman or a man has a furuncle or growths of genital warts / papillomas in the perineum, then you should contact dermatologist (make an appointment) for their diagnosis, and then to the surgeon to remove them.
If a man or woman has pain in the perineum that is sharp, sharp, also felt in the coccyx, increases when walking and weakens when standing, appeared after a traumatic effect on the coccyx area (for example, a blow, a fall, etc.), then this indicates coccyx injury. In such a case, you should contact traumatologist (make an appointment) or a surgeon.
If a man or woman has pain in the perineal region, felt on the skin, and not deep in the tissues, combined with severe itching and swelling, and possibly also rashes on the skin, then this indicates an allergic reaction, and in this case it should speak to allergist (make an appointment) and a dermatologist. A dermatologist should examine the skin to exclude the presence of any serious disease and confirm the allergic nature of pain and pathological changes in the skin.
If a woman or a man has severe pain and burning sensation in the perineum when urinating, which is combined with frequent urge to urinate, urine mixed with turbidity, blood, then this indicates urethritis, and in this case, you should contact urologist (make an appointment).
If a sharp pain suddenly occurs in the perineum of a man or woman, which is combined with burning, strong sensitivity and sensation of a foreign body in the pelvic organs, and also causes numbness along the inner surface of the thigh, increases when walking, in sitting and lying positions, does not decrease with time, this indicates an infringement of the pudendal nerve, and in this case it is necessary to turn to neurologist (make an appointment).
When pain in the perineal region in a man or woman is combined with pain in the anus or rectum, discomfort during bowel movements, possibly with the release of mucus, blood or pus from the rectum, chills and high body temperature, terminal bowel disease is suspected ( hemorrhoids, rectal fissures, proctitis, paraproctitis), and in this case, you should contact proctologist (make an appointment).
In all other cases, except for the above, men and women in the event of pain in the perineum should contact doctors of different specialties, since pain is provoked by diseases of specific genital organs.
When pain in the perineum occurs in women during pregnancy or after childbirth, you should contact gynecologist (make an appointment).
If pain in the perineum is combined with itching, inflammatory discharge from the genital organs (greenish, white, lumpy, etc.) or rashes in the vulva (pubis, labia, penis, etc.), then this is about genital infection (sign up) (genital herpes (make an appointment), candidiasis), in which case representatives of both sexes can contact venereologist (make an appointment) and, in addition, women - to a gynecologist, and men - to a urologist.
If pain in the perineum is combined with pain in the lower abdomen that does not have a clear localization, occurs periodically, passes on its own, does not increase over time, is not combined with any other symptoms from the genital organs (inflammatory discharge, rash, itching, bleeding and etc.), then chronic pelvic pain syndrome is suspected, in which case women should see a gynecologist, and men should see a urologist or andrologist (make an appointment).
If in men, pain in the perineum gives or is simultaneously felt in the lower abdomen, in the rectum, combined with pain in the testicles, enlargement of the scrotum, sensation of a foreign object in the rectum, feeling unwell, possibly with difficulty, frequent or painful urination, increased body temperature, increase when walking and straining, a tumor or inflammatory disease of the male genital organs (orchitis, epididymitis, prostatitis, prostate abscess, adenoma or prostate cancer) is suspected. In this case, you need to contact a urologist.
If a man has pulling, arching pains in the perineum after sex, which are also felt in the testicles, are combined with discomfort, heaviness and visible veins of the scrotum, increase when walking, spontaneously disappear after a few hours, then a varicocele is suspected, and in this case it is necessary to contact surgeon.
If a man develops a pulling, aching pain or burning sensation in the perineum, which is present almost constantly, aggravated in the sitting position and during bowel movements, inflammation of the bulbous urethral gland (couperitis) or seminal tubercle (colliculitis) is suspected. In this case, it is necessary to contact a urologist or andrologist.
If a woman develops pain in the perineum, combined with itching, burning, pain and abnormal vaginal discharge, all of which are aggravated by urination, vaginitis is suspected. In this case, you need to contact a gynecologist.
If a woman has throbbing pain in the perineum after sex or spontaneously, combined with swelling of the labia, a palpable and painful seal at the entrance to the vagina, enlarged inguinal lymph nodes, chills, weakness and fever, then bartholinitis is suspected. In this case, you need to contact a gynecologist or surgeon.
What tests and examinations can a doctor prescribe for pain in the perineum?
Pain in the perineum is provoked various diseases, and therefore, in the presence of this symptom, the doctor may prescribe various tests and examinations, a specific list of which is determined by concomitant symptoms that allow one to suspect the pathological process and the organ affected by it. Therefore, it is obvious that the choice of appointments is determined by the doctor on the basis of all clinical symptoms that allow him to make a preliminary diagnosis, and then confirm or refute it with the help of examinations. Consider what tests and examinations the doctor can prescribe for pain in the perineum caused by a particular disease.
If the pain in the perineum is associated with a past injury to this area of the body, then the doctor will prescribe Ultrasound (make an appointment) to assess the condition of tissues and identify possible causes of pain. If ultrasound is not informative enough, it may be prescribed magnetic resonance imaging (make an appointment). Further, if no serious diseases of the pelvic organs have been identified, therapy for post-traumatic syndrome is prescribed, aimed at the most complete restoration of tissues. But if diseases of the genital, urinary organs or intestines were detected during ultrasound or tomography, then the person is referred to the appropriate specialist, who, in turn, performs the necessary examination and prescribes therapy.
If a man or woman has boils, papillomas or condylomas on the skin of the perineum, which provoke pain, then the doctor may prescribe the following tests and examinations:
- General blood test (sign up);
- Bacteriological culture of the separated furuncle;
- Analysis of blood or genital secretions for the presence of human papillomavirus (PCR or ELISA) (enroll).
When a man or woman has growths of papillomas or condylomas in the perineum, the doctor prescribes a blood test and / or genital discharge for the presence of the human papillomavirus in order to understand whether the process of their formation is chronic or due to a simultaneous decrease in immunity. If papillomas / condylomas appeared due to a decrease in immunity, then they are simply removed surgical method and no specific treatment is given. But if the process is chronic, then after the removal of the growths, antiviral and immunomodulatory therapy is necessarily prescribed, which is necessary to prevent the formation of papillomas and condylomas again.
When a man or woman, after a traumatic effect on the coccyx region (bruise, blow, etc.), has a sharp pain felt simultaneously in the perineum and coccyx, aggravates when walking, weakens in a standing position, the doctor prescribes an x-ray of the coccygeal-sacral region of the spine. X-ray (sign up) allows you to identify fractures of the coccyx and to distinguish a bruise from a fracture. If the doctor suspects that the coccyx injury provoked the formation of an extensive hematoma in the soft tissues, then in addition to the X-ray, he may prescribe magnetic resonance imaging.
When a representative of either sex has pain in the perineum, which is strongly felt outside, and not deep in the tissues, combined with itching and swelling, and possibly with rashes on the skin, the doctor suspects an allergic reaction and prescribes the following tests and examinations:
- General blood analysis;
- Blood test for IgE concentration;
- Allergological skin tests by prick test or scarification (sign up);
- Analysis of hypersensitivity to various allergens by determining the concentration of specific IgE in the blood (guinea pig, rabbit, hamster, rat, mouse, latex, orange, kiwi, mango, pineapple, banana, apple, peach, common ragweed, common wormwood, gauze white, plantain, Russian thistle, fragrant spikelet, perennial rye, timothy grass, cultural rye, woolly bukharnik, for house dust and house dust mites).
When a representative of either sex feels severe pain and burning in the perineum, which may be present constantly and intensify or appear only when urinating, combined with frequent urge to urinate, urine mixed with blood, turbidity - the doctor suspects urethritis and prescribes the following tests and examinations:
- General blood analysis;
- General urine analysis ;
- Three glass urine sample;
- Urethral swab (enroll);
- Bacteriological culture of urine and urethral discharge;
- Analysis of blood or urethral discharge for the presence of pathogens of sexual infections ( for chlamydia (make an appointment), mycoplasmas (sign up), gardnerella, ureaplasma (sign up), Trichomonas, gonococci, Candida fungi) by PCR or ELISA;
- Ultrasound of the bladder (make an appointment).
When a member of either sex suddenly has a sharp pain in the perineum, combined with burning, strong sensitivity and sensation of a foreign body in the pelvic region, numbness on the inner surface of the thigh, and the symptoms are aggravated by walking, sitting and lying down, the doctor suspects an infringement of the pudendal nerve. In this case, the diagnosis is made mainly on the examination data and characteristic symptoms. Additionally, to identify the cause of the pinched nerve, the doctor may prescribe magnetic resonance imaging. And in order to identify the speed of the signal along the nerve and the response of the muscles to the impulse - electroneurography, which allows you to understand which surrounding organs or tissues put pressure on the nerve and provoke pain.
If in representatives of either sex, pain in the perineum is combined with pain in the anus or rectum, discomfort during defecation, possibly with the release of mucus, blood or pus from the rectum, chills and high body temperature, a disease of the terminal intestines (hemorrhoids) is suspected. , rectal fissures, proctitis, paraproctitis). In this case, the doctor prescribes the following examinations:
- Inspection of the anus and perineum;
- Digital rectal examination;
- General blood analysis;
- Coprological analysis of feces (with a reaction to occult blood);
- Feces on worm eggs;
- Analysis of feces for microflora (appointed only if dysbacteriosis is suspected);
- A swab from the area around the anus (assigned only if a fungal infection or genital herpes is suspected).
The above studies and analyzes are mandatory assigned and performed in the first place, and they give the doctor a fairly wide range of information about the state of the terminal intestine. Based on the information received, the doctor makes a preliminary diagnosis and, if necessary, prescribes additional examinations. For example, if hemorrhoids are detected, then only anoscopy (make an appointment). But if proctitis, paraproctitis, rectal fissures are suspected, then anoscopy is prescribed, sigmoidoscopy (make an appointment)/colonoscopy (make an appointment). If the pathology is severe, there are fistulas, adhesions, etc., the doctor may also prescribe specific and rarely used studies, such as fistulography (sign up), probing, etc. If pain in the perineum bothers a woman after childbirth, then the doctor prescribes and performs an ultrasound scan, as well as gynecological two-handed examination (make an appointment) in order to identify deformities, strictures of internal soft tissues that can provoke pain.
When pain in the perineum is combined with itching, inflammatory discharge from the genital organs (greenish, white, lumpy, etc.) or rashes in the vulva (pubis, labia, penis, etc.), then it is suspected genital infection(genital herpes, candidiasis). In this case, the doctor prescribes a smear from the urethra and vagina, bacteriological seeding of the discharged vagina and urethra, which make it possible to identify the causative agent of the infection. If, according to the results of these tests, the causative agent of the infection is not identified, then a blood test is prescribed, the discharge of the urethra or vagina for the presence of a pathogenic microbe (gonococcus, Trichomonas, chlamydia, mycoplasma, ureaplasma, fungi of the genus Candida, herpes viruses, etc.) using PCR and ELISA methods .
When pain in the perineum is felt simultaneously with pain in the lower abdomen, does not have a clear localization, occurs periodically, disappears on its own, does not increase with prolonged existence, is not combined with other symptoms from the genital organs (inflammatory discharge, rashes, itching, bleeding, etc. .) - the doctor suspects chronic pelvic pain syndrome. Since this is a syndrome in which a person only experiences pain, but does not have any pathologies of the internal organs, this is a diagnosis of exclusion. In other words, a man or woman is given a complete examination (general, biochemical blood tests, general urinalysis, blood coagulation analysis, Ultrasound of the pelvic organs (high body temperature, aggravated by walking and exertion, then a tumor or inflammatory disease of the male genital organs is suspected (orchitis, epididymitis, prostatitis, prostate abscess, adenoma or prostate cancer), and in this case, the doctor prescribes the following tests and surveys:
First of all, the doctor prescribes a general blood and urine test, and also performs a digital examination of the prostate gland. Based on the data obtained from these primary simple studies, the doctor makes a preliminary diagnosis and already knows for sure whether a person has a tumor or inflammatory disease of the genital organs.
Further, if a tumor disease is detected, the doctor prescribes a blood test to determine the level of prostate-specific antigen (PSA), ultrasound of the prostate, bladder and intestines (sign up), and prostate biopsy (make an appointment). In some cases, magnetic resonance imaging may be additionally prescribed to detect the presence of metastases or assess the condition of soft tissues. If a fistula is suspected, ureteroscopy (make an appointment), cystoscopy (make an appointment), anoscopy.
If, according to the results of primary tests, an inflammatory disease is detected, then the doctor prescribes a smear from the urethra, a study of prostate secretion, urine culture and prostate secretion in order to identify the causative agent of the infectious-inflammatory process. Additionally, ultrasound is performed to assess the condition of the genital organs.
If a man suffers from pulling, arching pains in the perineum after sex, which radiate or are simultaneously felt in the testicles, are combined with discomfort, heaviness and visible veins of the scrotum, increase when walking, spontaneously disappear after a few hours - the doctor suspects varicocele, and prescribes the following tests and examinations:
- Feeling the testicle in a horizontal, vertical position and when straining;
- Spermogram (sign up);
- Venography;
- Ultrasound of the kidneys (make an appointment) and testicles;
- Magnetic resonance imaging abdominal cavity(sign up);
- Dopplerography (enroll);
- Rheography (sign up).
When a man has a pulling, aching pain or burning sensation in the perineum, which is present almost constantly, aggravated in the sitting position and during bowel movements, cuperitis or colliculitis is suspected, and the doctor prescribes the following tests and examinations:
- General blood analysis;
- General urine analysis;
- Three glass urine sample;
- Microscopy of prostate secretion and urethral smear;
- Bacteriological culture of prostate secretion, urethral discharge and urine;
- ureteroscopy;
- radiopaque urethrography (make an appointment).
When a woman experiences pain in the perineum combined with itching, pain and abnormal vaginal discharge aggravated by urination - the doctor suspects vaginitis and prescribes the following tests and examinations:
- Bimanual gynecological examination;
- Examination of the genital organs in the mirrors;
- Vaginal smear for flora (make an appointment);
- Bacteriological culture of the vaginal discharge;
- Detection of causative agents of sexual infections (chlamydia, mycoplasma, gardnerella, ureaplasma, trichomonads, gonococci, Candida fungi) in the blood and vaginal discharge by PCR and ELISA.
When a woman suffers from throbbing pains in the perineum that appear spontaneously or are provoked by sex, combined with swelling of the labia, a palpable and painful seal at the entrance to the vagina, enlarged inguinal lymph nodes, chills, weakness and fever - the doctor suspects bartholinitis and diagnoses based on the examination of the patient. After the detection of bartholinitis, treatment is carried out. If the process is long-term, prone to chronicity, then a bacteriological culture of the separated Bartholin's gland is performed with the determination of sensitivity to antibiotics. This is necessary in order to prescribe antibiotics that are most effective against the causative agent of the infectious-inflammatory process after opening the duct of the gland and removing the purulent contents. Such a targeted prescription of antibiotics minimizes the risk of re-bartholinitis in the future.
Before use, you should consult with a specialist.As for pregnant women, pain in the perineum usually occurs from the 35th week of pregnancy. At this point, the baby applies pressure to parts of the body below and around the fetus, including the back, perineum, and legs. In this case, the pain in the perineum has a stabbing character.
Relatively early term pregnancy, such pains threaten with a probable miscarriage. Pregnancy is the period when a woman's body is completely rebuilt, preparing for childbirth, which means that the hip bones move apart, which causes pain in the perineum during pregnancy.
Often the child is in a position that puts pressure on the sciatic nerve. In this case, the pregnant woman feels a sharp pain that makes it difficult to move, and does not go away even at rest.
Regarding the treatment of pain, unfortunately, there are no such methods now, and the pregnant woman must endure pain until the end of pregnancy. But, it is extremely important to control the condition of a woman in this position, as pain in the perineum can mean varicose veins in this area.
Pain in the perineum before childbirth
It is impossible to call pain in the perineum before childbirth a normal phenomenon, but nevertheless, there is no particular cause for concern either. It is clear that it is not easy for a pregnant woman before childbirth, and then there is discomfort due to pain. During this period, it is not recommended to take painkillers as their action may affect the child's condition. Yes, and besides, there is no point in using them, because the pain is caused by the pressure of the fetus on the hip part of the body. It is impossible to eliminate the pressure because the fetus is already almost formed and is preparing for birth.
Pain in the perineum before childbirth warns of the imminent birth of a baby. But, the absence of pain signs in the perineum cannot say otherwise, as not every pregnant woman experiences them.
Pain in the perineum after childbirth
Childbirth is a process that in many women proceeds in a traumatic way, breaks and other phenomena are likely. The type of pain depends on the severity of the injury. After childbirth, pain in the perineum can be both aching and sharp.
If the pain in the perineum after childbirth arose due to stretching and is accompanied by swelling, then it disappears within a few days, and without medical assistance. If we talk about tears and stitches, then the duration of pain is much longer. It is impossible to say the exact period of pain because it all depends on the number of stitches, the depth of the gap and the individual characteristics of the woman's body. Regarding the seams, I would like to add a few words about the rules of hygiene. No matter how painful it is, you need to wash more often than usual, as wounds (in our case, tears) are the best environment for the appearance and reproduction of infections.
Pain in the perineum in men
For some reason, many people think that pain in the perineum is characteristic only of women. But, as it turned out, this fact is not reliable, because men can also experience pain in the perineum.
What can cause pain in the perineum in men? There are several options for pain symptoms in the perineum:
- prostatitis;
- abscess;
- malignant tumor.
Before talking about treatment, it is necessary to establish an accurate diagnosis. The pain itself can be relieved with painkillers Ketons, Analgin, or other drugs that are preferred for a person suffering from pain.
If the diagnosis is still known, and it turned out to be prostatitis, how to treat it?
Here, too, there is no definite answer, since prostatitis can be both bacterial and non-bacterial. In addition, prostatitis is divided into categories:
- I - acute bacterial prostatitis;
- II - chronic bacterial prostatitis;
- III - chronic non-bacterial prostatitis;
- III A - chronic inflammatory pelvic pain syndrome;
- III B - prostatodynia;
- IV - asymptomatic prostatitis.
For the treatment of category I prostatitis, tests should initially be taken to determine the sensitivity of the flora to certain antibacterial drugs. Usually, antibiotics are included in the treatment: Quinolone, Tetracycline, Trimethoprim - Sulfamethoxazole.
How to use them:
- "Quinolone" is a synthetic antibiotic that should not be taken without a doctor's recommendation as it can cause a number of side effects: abdominal pain, nausea, vomiting, diarrhea, headache, fatigue, drowsiness. As for the dosage and duration of taking the medication, then you can decide by consulting with your doctor.
- "Tetracycline" is an antibacterial drug. The form of its release in tablets and ointment. In this case, tablets are needed. Doses for adults: 2 mg - 4 mg 3 - 4 times a day. The daily dose should not exceed 8 mg. The treatment period is 5 - 7 days. Side effects: increased intracranial pressure, gait disturbance, loss of appetite, nausea, vomiting, dizziness, diarrhea, lesions of the oral mucosa and gastrointestinal tract, skin reactions, pancreatitis, skin pigmentation. Contraindications include: hypersensitivity to the drug, fungal diseases, problems with the liver, kidneys, age under 8 years.
- "Trimethoprim - Sulfamethoxazole" - a combination of antimicrobial drugs: "Trimethoprim" and "Sulfamethoxazole". Assign, both for intramuscular injections, and for oral administration. It all depends on the recommendations of the doctor. The same can be said about dosages. Despite the presence of instructions, the attending doctor independently sets the course of treatment as he knows the results of the examination.
Antibacterial therapy in the case of chronic bacterial prostatitis lasts from 2 to 4 months. At the very beginning of treatment, the infectious agent of the disease is eliminated, the immune state is restored, and only then attention is paid to the regulation of the functional activity of the prostate. At proper treatment 60% of patients achieve absolute recovery. But this does not mean that the remaining 40% should lay down their hands and come to terms with the diagnosis. For them, treatment may be longer than 2 to 4 months. Options for surgical extraction of the affected parts of the prostate are not excluded.
In this, as in the previous case, medicines are used to eliminate bacteria "Timetoprim - Sulfamethoxazole" and the like. Plus, anti-inflammatory drugs are needed: Allopurinol, alpha-blockers: Gitrin, Flomax and others.
- "Allopurinol" is intended to restore the genitourinary system, respectively, using this drug has an effect on the kidneys, which means that the doctor should take the dosage and duration of treatment.
- Alpha blockers are designed to treat BPH by relieving tension in the smooth muscle tissue of the prostate, increasing the flow of urine from the bladder. Usually their doses are as follows: one mixture 1-2 times a day.
The next category of prostatitis - without the presence of bacterial infections is more common than other types of prostatitis. This disease affects men of any age. The symptoms in this case are inconsistent, that is, "today it hurts, but tomorrow it doesn't." Can be treated with folk remedies.
Consider asymptomatic stomatitis. The patient does not feel pain or other identification marks. It is possible to identify such a disease only after passing tests, where it is visible high level leukocytes in the seed. The treatment period is on average 2 weeks, which consists of taking antibiotics.
Folk ways for the treatment of prostatitis:
- They say that hazel is able to get rid of prostatitis in just a week after the course of treatment. So, the recipes for a decoction based on hazel: -
- hazel bark - 1 tablespoon per 1 cup of boiling water. Infuse the resulting liquid for half an hour. Strained broth take a quarter cup 4 times a day;
- this recipe is similar to the previous one, only hazel leaves are used instead of hazel bark.
It is better to alternate the intake of herbal tinctures, for example, today - a decoction from the bark of hazel, tomorrow - from the leaves. So, throughout the week.
- It turns out that parsley is able to prolong male power for many years, the main thing is to know how to cook it correctly. The most popular options for treating prostatitis with parsley are:
- 1 tablespoon fresh parsley 3 times a day 30 minutes before meals;
- chopped parsley seeds, namely, 2 tablespoons of the prepared powder, pour one glass of boiling water. Let it brew for 15 minutes. Drink 1 tablespoon 4-6 times a day.
Abscess and malignancy are more serious causes of pain in the perineum. And, of course, the treatment requires more radical methods such as surgery, chemotherapy. There is no need for medication alone.
In addition, pain in the perineum in men and women is often associated with chronic pelvic pain syndrome. In this case, a person experiences pain in the lower abdomen, which radiates to the perineum. In such a situation, treatment is symptomatic.
Pain in the perineum in women
Pain in the perineum in women, as in men, can occur against the background of certain diseases:
- urethritis - inflammation of the urethra. Its symptoms: cramps, burning during urination. Pain is present not only at this moment. The causes of urethritis are quite diverse:
- hypothermia;
- malnutrition;
- traumatic sexual intercourse;
- gynecological diseases that violate the microflora of the vagina;
- urolithiasis;
- medical interventions, such as a catheter in the bladder or cystoscopy.
Treatment of urethritis in women is carried out by two doctors, a gynecologist and a urologist. The exact method of treatment can be said after the factor in the appearance of the disease is identified. The therapy is based on three stages:
- regeneration of the functions of the wall of the urethra;
- restoration of the natural microflora of the vagina;
- normalization of the immune system.
- Cooperitis is a disease peculiar to men and women. Nowadays, it occurs quite often, and it is almost impossible to detect. If we analyze the diagnosis in detail, then for women - inflammation of the Bartholin glands; men - inflammation of the bulbourethral glands in the urethra. The disease has two courses: acute and chronic. In the case of acute cuperitis, the symptoms are: discomfort in the anus, difficulty urinating, fever, chills. If the disease has become severe, then an abscess of small size is formed in the perineal area. It is possible that the appeared abscess causes pain in the perineum.
Chronic cooperitis differs from acute in that there are many abscesses in this case.
In both situations, the pain in the perineum is pulling and constant. The pain intensifies after the next urination. Patients also complain of discomfort after intercourse.
How to treat couperitis in women?
Cooperitis is treated with antibiotic therapy (as with urethritis), potassium iodide iontophoresis. The entire course of treatment takes place under the strict supervision of doctors. Self-medication with cooperite is contraindicated.
- vaginitis - gynecological disease, inflammation of the vaginal mucosa.
What are the causes of vaginitis?
- some types of STDs: trichomoniasis, gonorrhea, chlamydia, mycoplasmosis, and so on;
- weakened immunity due to the presence of infectious diseases;
- disorders associated with the endocrine function of the endocrine glands, for example, kkimax, ovarian disease, obesity, diabetes mellitus, and so on;
- abortions, insertion of foreign objects into the vagina and the like;
- inappropriate hygiene rules, including sexual intercourse;
- abuse of antibiotics;
- an allergic reaction to vaginal preparations, for example, candles, a condom;
- streptococci, staphylococci and other bacteria.
At the moment, most cases of the disease are caused by mycoplasmas and chlamydia.
Vaginitis symptomatically looks like this:
The acute form of vaginitis occurs with the presence of purulent abundant discharge.
Vaginitis, the factor of which is Trichomanidae, has a distinctive feature - discharge with a fishy smell.
Fungal vaginitis - white discharge, curdled consistency.
In addition to discharge, all types of vaginitis are characterized by itching, swelling and redness of the genital organs. Intimate contact can hurt. When urinating, a woman feels a burning sensation. The disease is accompanied by pain in the back and lower abdomen.
The chronic stage is the most serious and the course of treatment is longer. Itching and discomfort in the vaginal area practically does not bother. And, here, recurrence is not excluded.
Treatment of this disease is to initially eliminate the causative agent of vaginitis. During the entire course, it is necessary to completely abandon intimate contacts. Testing of the partner and possible further treatment, otherwise, the treatment of the woman may be pointless, as her partner may re-infect her. Local treatment can be carried out by folk methods, which in this situation is the best therapy:
- sedentary warm baths from chamomile infusion;
- thick, purulent, mucous discharge is easily eliminated by douching the vagina. To do this, you need to prepare a solution of bicarbonate soda: teaspoons per 1 cup warm water. After 20 minutes, do the same manipulations only with potassium permanganate;
- discharges provoked by trichomonas and the like are eliminated in this way: zinc sulfate: 2 teaspoons per 1 liter of warm water; copper sulfate: 1 teaspoon per 1 liter of water. Douche with the resulting solutions daily, preferably at night;
- as soon as the discharge has stopped, a decoction of oak bark is used for douching: 1 tablespoon of oak bark per 1 cup of boiling water. The broth is covered with a lid and allowed to cool to room temperature.
- bartholinitis can be formed for various reasons, but most often they include microbes: gonococci, escherichia, staphylococci, and so on.
How does bartholinitis manifest itself?
The general picture looks like this: weakness, malaise, high body temperature. External changes in the genital organs are inherent: redness, swelling, abscess formation. In the event of a breakthrough of the abscess, the general condition of the woman is normalized.
There is a chronic form of the disease. It is possible even the formation of a cyst. After treatment, the disease may return.
Methods of treatment.
If bartholinitis is purulent, then the only effective solution is surgery.
The acute stage is treated in a less radical way: the patient needs rest. Local therapy: cold, antibacterial agents (depending on the factor), sitz warm baths with the addition of potassium permanganate solution - 1: 6000.
Medications that are prescribed for the treatment of bartholinitis:
- a) antibacterial:
- Sumamed, Azitrox, Azithromycin, Amoxicillin, Ospamox, Amin;
- Doksinat, Doxycycline, Doksibene, Medomycin, Solutab, Unidox;
- Klabaks, Klacid, Clarithromycin;
- Dalacin, Klimitsin, Clindamycin, Clindamycin, Klandafer, Klinoksin;
- "Septrin", "Groseptol", "Biseptol";
- "Oflotsid", "Ofloksatsin", "Ofloksin", "Tarivid";
- "Aquacipro", "Afenoxin", "Arfloks", "Ciprofloxacin", "Ciprinol", "Liprokhin", "Proxacin", "Recipro", "Ciprinol".
- b) sitz baths with the addition of:
- potassium permanganate solution. The color of the water should be slightly pink, as an excessive amount of manganese can disrupt the microflora of intimate places;
- decoction of chamomile: 1 tablespoon of chamomile officinalis to 1 cup of boiling water. Within half an hour the potion is ready;
- infusion of calendula. Cook according to the principle of a decoction of chamomile.
Symptoms of pain in the perineum
Symptoms of pain can be completely different and may or may not have accompanying general ailments: fever, fatigue, drowsiness, and so on. Pain in the perineum depends on the type of disease. It can be stabbing with itching, sharp periodic, acute constant, aching, burning, and so on.
If we talk about severe pain in the perineum in men, then most likely the diagnosis is acute prostatitis. But we can say for sure only after receiving the results of the tests. To exclude absolute impotence, men should not look for a solution to the problem in search engines, but with a urologist and an infectious disease specialist. The same pain can provoke urethritis, which is aggravated by urination. Severe pain that affects the rectum may signal the presence of a prostate abscess. In this case, problems with the stool are significantly noticeable; elevated body temperature. In no case should such a phenomenon be triggered as it is a precursor of prostate cancer. You can eliminate the pain of an abscess with the help of narcotic drugs (which we will not talk about, since any drug with narcotic properties is prescribed strictly on the recommendation of a doctor).
Sharp pain in the perineum can signal an infringement of the pudendal nerve. It subsides when a person is sitting or standing, in general, does not walk and does not create movement with the legs. At the time of walking and lying down, the pain becomes unbearable. A pinched nerve can create a feeling of numbness in the thigh.
Pain radiates to the perineum
Pain symptoms in the lower abdomen in men occur less frequently than in women. They can indicate many diseases, respectively, a trip to a urologist or andrologist is required. No matter what pain is sharp, dull, it can radiate to the groin, rectum and perineum.
Feeling pain in the perineum, a person often believes that it is the perineum that is the source of pain, forgetting that in fact the pain can radiate to the perineum.
If the pain covers the leg, genitals, perineum, and at the same time there is an urge to urinate, vomiting, then this is a likely sign that the patient needs to be urgently hospitalized in the urological, surgical department (if it is impossible to fix the problem at home) as it is symptoms of an attack of renal colic. The signs of this attack include unbearable pain, which completely covers the person. The patient in this state can fidget on the bed, crawl on the floor, "climb the walls" from pain. How to relieve pain in this position?
- narcotic analgesics: "Bupremen", "Pyritramide", "Butorphanol", "Bupresik" and others;
- heating pads for the lumbar region;
- relieves spasm of the ureter by immersing the patient in a warm bath. This procedure provokes the passage of the stone.
In the absence of an attack, therapy has the basis of normalizing metabolism in order to avoid stone formation.
In diabetes, pain can also radiate to the perineum. During this period, the patient experiences sugar diabetes, which causes pain in the perineum. In this case, the disease can last for decades, and sometimes a lifelong diagnosis.
Drawing pain in the perineum
Pulling pain in the perineum is typical for men in the case of chronic inflammation of the prostate (chronic prostatitis), colliculitis, urethritis. Sometimes a burning sensation joins the pain in the perineum. These painful sensations cannot be called unbearable, but debilitating and tiring is a suitable interpretation, especially if they are constant.
If such pain in the perineum increases in the sitting position, then it is likely that the diagnosis is couperitis. In this case, the pain may become more intense if purulent development occurs in the gland.
Pain with pulling and aching symptoms is characteristic of pregnant women and women who have just given birth.
Pain in the perineum
Pain in the perineum and in its area can talk about many problems, but this does not mean that all of them are inherent in a person with pain symptoms. The body of each person is individual, respectively, that each disease suffers in its own way. But to turn a blind eye to the presence of pain, even minor, in no case, it is impossible.
Pain in the perineum can signal the presence of an infection (chlamydia), an abscess, injury, or skin inflammation. Even too tight and tight jeans with their seams can rub and provoke pain in the crotch area.
The most important thing is to establish an accurate diagnosis and undergo the correct course of treatment.
Sharp pain in the perineum
Acute or sharp pain in the perineum is not a joke!
If a man feels a sharp pain, then it may be acute prostatitis. But again, it's impossible to say for sure. The same symptoms are possible with purulent formations, both in men and women. Similar pain symptoms may be a sign of acute urethritis. In the latter case, the pain is aggravated by urination. It is also accompanied by stool retention. In this case, the body temperature can reach a maximum level.
Sharp and severe pain in the perineum can sometimes indicate cancer or a pinched pudendal nerve. The variant of injury or the formation of a hematoma due to traumatic factors is not excluded. As a result of injuries, a person from pain shock can lose consciousness.
Stitching pains in the perineum
Basically, stabbing pain in the perineum is experienced by women on recent weeks pregnancy. If the pain is not accompanied by unusual discharge, then there is no reason for the pregnant woman to worry, as the development and growth of the fetus will naturally affect its mother. As for discharge, consultation with a gynecologist is extremely necessary.
Colpitis and vaginitis are indicated by symptoms: stabbing or shooting pain in the perineum, vaginal discharge. During pregnancy, these diseases are more dangerous than in the normal state. So, in more detail:
- colpitis during pregnancy:
- symptoms:
- the mucous membrane of the vagina becomes swollen and acquires a red tint;
- a pregnant woman feels itching and burning in the genital area;
- pressing and bursting pains in the pelvic area and in the lower abdomen;
- purulent discharge.
- what is the danger of colpitis during pregnancy:
Colpitis itself is not particularly dangerous, but its consequences are terrible because the infection can affect not only the general condition of the pregnant woman, but also her fetus. In addition, the inflammatory process in the vagina can cause miscarriage or premature birth.
- how to treat colpitis during pregnancy? Definitely, no initiative, only a gynecologist and his strict supervision are able to competently resolve the situation. Any self-medication can affect the condition of the child and the future possibility of conceiving a child.
Antibiotics and chemicals the doctor chooses as their improper use threatens with unpleasant consequences for the child. In addition, the treatment includes physiotherapy, herbal infusions, acid baths, the use of ointments and a special diet.
- vaginitis during pregnancy. Everything is much more complicated here, for the reason that not all medications allowed for pregnant women such as Klindacin, Dalacin, Noliin. Ineffective medicines, but safe "Pimafucin" and "Nystatin".
If the gestational age is up to 15 weeks, then Betadine, Vagotil, Terzhinan can be used (but, again, only on the recommendation of a doctor).
Aching pain in the perineum
Pain can be accompanied by other symptoms, or it can just whine, causing discomfort. If a man has a dull aching pain in the perineum along with pain in the testicles or in one testicle, then it is possible that this is a sign of hypothermia (sitting on a cold one, for example) or prostatitis. In this case, tests and ultrasound are essential.
As for women, aching pain in the perineum most often refers to pregnant women. The causes and symptoms of such a consequence have been discussed above.
It is impossible to say for sure what exactly could cause aching pain in the perineum, as the body of each person reacts to a particular disease in its own way. For some, the inflammatory process occurs asymptomatically, while someone writhes in pain. But, no matter what friends say, like “Yes, I had that. It's okay, ”or online advisers, a visit to the doctor cannot be postponed.
Shooting pain in the perineum
Such symptoms are typical for pregnant women who are about to become mothers. But there are situations when the cause of such a consequence can be diseases:
- an abscess can cause a sharp shooting pain in the perineum;
- hematoma - the result of injury;
- trauma;
- diseases associated with the rectum, such as hemorrhoids;
- consequences after childbirth;
- skin diseases, including an allergic reaction to underwear (here the pain in the perineum can be shooting if the irritation looks like a wound).
In addition to the above reasons, this phenomenon is typical for athletes when their muscles are stretched, for example, during training, they incorrectly sat on the twine.
Pain when walking in the perineum
If the pain in the perineum increases when walking, then the following health problems may be its provocateurs:
- coccyx injury;
- orchitis;
- dropsy of the testicles;
- epididymitis.
Consider the diseases described above.
Orchitis is inflammation of the testicles or testicles. It can develop on the basis of urethritis, prostatitis, vesiculitis, epididymitis, as well as on the basis of trauma or FLU. May be acute or chronic.
Its symptoms: immediately pain appears in the affected testicle. Further, when the disease is gaining momentum, the patient feels pain in the perineum, in the lower back. The scrotum in the side where the inflammation occurred (right or left) doubles. Her skin takes on a smooth and red surface, becomes hot. This disease is also characterized by general malaise: weakness, temperature up to 39 ° C, chills, fever, headache, nausea.
The disease can go away on its own within 2 to 4 weeks. But one should not particularly count on such an outcome, since the lack of timely treatment can cause suppuration in the affected area, which in medicine is called an abscess.
Regarding the treatment itself, its main rule is complete rest, bed rest. Compliance with the diet is mandatory: the absence of spicy and fatty foods, alcohol. Antibiotics "Aminoglycosides", "Cephalosporins", enzymes "Macrolides" - "Erythromycin", "Sumamed", "Tetracyclines" - "Doxycycline", "Metacycline", absorbable preparations, vitamins E, local application of a cold compress, antibacterial drugs "Vidoccin" are prescribed. ”, “Microflox”, “Norilet”, “Noroxin”, “Ospamox”, “Oflotsid”, “Renor”, “Forcef”. At the end of the treatment, thermal procedures and physiotherapy. But, initially eliminate the factor that provoked the occurrence of orchitis.
IN traditional medicine The following treatments are known:
- ingredients: St. John's wort, chamomile and elderberry flowers, lingonberry leaves, black poplar buds;
- cooking method: all components must be in equal proportions, that is, one to one. The mixture of plants should be crushed. Now about the doses: 2 tablespoons of the resulting collection of herbs are poured with half a liter of boiling water, leave for 8 hours;
- How to use: 2 tablespoons 5 times a day.
- ingredients: hop flowers 100 g;
- preparation method: pour 0.5 l of boiling water over the plant. The decoction is infused for half an hour;
- How to use: Half a glass twice a day.
Lotions from cabbage leaves settled in vinegar or crushed flax seeds.
A dropsy of the testicles or hydrocele is a process when fluid accumulates in the sinuses of the testicle or testicles. The consistency of a liquid may consist of:
- blood;
- exudate - pus of an inflammatory nature;
- transudate - non-inflammatory fluid;
- liquid - after removal of a hernia;
- consequences of operations: varicoele, impaired outflow of venous blood from the testicle;
This disease can be:
- congenital and acquired;
- acute and chronic;
- unilateral and bilateral.
Dropsy of the testicles (testicles) is characteristic of young people 20-30 years old, newborns.
Symptoms of a hydrocele: an inflamed testicle increases in size. The testicle itself is usually not palpable through the skin. At the same time, the skin becomes elastic. Pain in testicles of aching type. Sometimes the general body temperature rises. As a result of the abundant accumulation of fluid, discomfort appears in the process of walking and wearing underwear. Also, with an excessive amount of fluid, the wall of the testicle can tear. During which the scrotum increases, and the pain becomes acute. The pain also radiates to the perineum, especially when walking.
And now about the treatment of hydrocele. Drug therapy and folk remedies are useless. Only operational way, or rather, the removal of accumulated fluid from the testicle will bring results.
Epididymitis is one of the types of inflammation of the epididymis, which is possible at any age, even in children. It has several forms: chronic and aggravated. The nature of the disease can be as follows: serous, purulent and infiltrative. It can manifest itself against the background of an infection from the bladder, intestines, prostate, which enters the epididymis. Sometimes the causative agents of the disease are influenza, tuberculosis, tonsillitis, and so on. Such a complication can cause perineal trauma, including surgery. Infections related to STDs: chlamydia, gonococci, mycoplasmas, ureaplasmas, Trichomonas - one of the causes of epididymitis. In addition, hypothermia can provoke the occurrence of such a disease.
Let's move on to the symptoms. Epididymitis is characterized by sharp pain in the testicles and perineum, which is aggravated by walking. The scrotum in the area of inflammation is enlarged and edematous; acquires a red light; the skin becomes smooth, even glossy. Body temperature rises to 39 C plus fever, headache and joint pain. Unlike testicular torsion, the pain is relieved by lifting the scrotum.
Chronic epididymitis may be asymptomatic or with mild symptoms. But still, chronic epididymitis makes itself felt in the process of walking - pain in the testicle.
Treatment depends on the form of the disease. Naturally, a normal adult with such a problem will definitely go to the hospital, where he will be prescribed antibiotic therapy - to eliminate the causative agent of the disease, anti-inflammatory therapy.
Acute epididymitis is treated with antibacterial drugs, general antibiotics, painkillers, cold compress on the perineum; children are prescribed sulfa drugs, for example, "Bactrim". This also includes bed rest. In addition, in this case, it is recommended to wear tight swimming trunks or a jockstrap. Treatment includes following a diet that prohibits the use of spicy, fatty, fried, smoked foods. When the pain subsides, physiotherapy is prescribed:
- microwave therapy,
- laser therapy,
- magnetotherapy.
If the treatment did not bring positive results, then the epididymis is removed.
Pressing pain in the perineum
Unpleasant pain is such that it directly presses on the perineum and presses on the anus, indicating that the pregnant woman will give birth soon. If the gestation period is too short, then this is really a cause for concern, as there is a possibility of a threatened miscarriage. For the 36th (and beyond) weeks, this feeling is normal.
Pressing pain in the perineum in men can indicate various possible problems: prostatitis, perineal injury, hypothermia.
As for non-pregnant women, the possibility of a "cold" is more than likely.
No matter how the pain in the perineum is pressing or shooting, you should not postpone the consultation of the doctor. As we have said, everyone in their own way to endure any disease. But basically, any pain in the perineum is directly related to diseases of the genitourinary system or intestines, for example, hemorrhoids.
Pain in the perineum after sex
Consider first the causes of pain in the perineum and testicles during and after sex in men. Such a fact may indicate varicose veins of the testicle or spermatic cord, referred to in medicine as a varicocele. With such a disease, pain in the perineum is not intense, but increases in a calm state, and subsides when walking. The duration of pain ranges from several minutes to several hours. The pain goes away on its own. Prostatitis can also be a consequence of pain in the perineum during sex.
Varicocele at the very beginning of its development does not need treatment. But it is still worth eliminating the causes of stagnant processes in the small pelvis (constipation).
The second stage of varicocele, which is characterized by intense pain, drug treatment won't be enough. In this case, the operation is necessary in order to avoid the third stage.
Women experience pain in the perineum during and after intercourse, usually due to bartholinitis. The pain is throbbing and lasts for several hours after sex, and then disappears.
Pain in the perineum on the left
Pain in the perineum on the left side in men and women indicates an inflammatory process of the left appendages or testicle (ovary). Plus, with inflammatory processes in the kidneys, pain can be given to the perineum.
If we talk about men's health, the variant of prostatitis of the epididymis of the left testicle, varicocele on the left testicle, torsion of the left testicle, orchitis of the left testicle, infections, hypothermia and injuries of various nature are not ruled out.
Pain in the perineum on the left in women can signal all the diseases that have been discussed in this article. Just like men, women can experience pain in the perineum due to hypothermia.
Among other things, nerve pinching, muscle strain, joint injuries (dislocations, bruises) can provoke pain in the perineum, both on the left and on the right side.
Dull pain in the perineum
Dull pain in the perineum can be a sign of skin irritation (sometimes accompanied by itching and burning), prostatitis, urethritis, colliculitis, cuperitis. As for cuperitis, when the gland is suppurated, dull pain is replaced by a sharp one.
Women complain of dull pain in the perineum, usually either during pregnancy or after childbirth. In the first case, the growing fetus presses on the perineum, back, and sacrum. Plus, the woman's body is preparing for childbirth, that is, the bones expand. In the second option, childbirth is a stress for the body, the muscles are stretched, there is pressure on the bones and joints. Often, women who have given birth suffer from hemorrhoids, which, by the way, is also the reason for pain syndromes in the perineum.
Pain in the perineum after urination
At the time and after urination, pain in the perineum is characteristic of women after childbirth (or people who have survived surgery in the perineal area), if stitches have been applied. During this period, special attention should be paid to personal hygiene, as unhealed wounds are the best environment for infection to multiply.
Skin irritations in the perineal region can cause the same effect in both women and men. In this case, it is necessary to contact a dermatologist in order to avoid penetration of various kinds of infections.
Men should take such symptoms more seriously, since pain in the perineum after urination can be a signal of prostatitis, cooperitis, urethritis.
Pain in the perineum when urinating
Pain in the perineum during urination, similar to pain after urination, can indicate several possible problems such as:
- perineal injuries (here, surgical intervention, ruptures after childbirth),
- skin inflammatory processes;
- problems regarding men's health: prostatitis, cooperitis, urethritis.
If, at the time of urination, pain in the perineum is accompanied by itching or burning of the genitals, then the option of having gonorrhea or chlamydia is not excluded. The same symptoms are characteristic due to hypothermia of the body, let's say a cold bladder or kidneys may manifest themselves in this way:
- itching, burning, pain in the perineum when urinating, pain in the lower abdomen and in the lumbar region,
- difficulty urinating,
- copious or small amount of urine,
- frequent or infrequent urination,
- swelling on the face, legs, arms (not always),
- elevated body temperature (not always),
- in the case of inflammatory processes of the kidneys, vomiting is possible.
The list of additional symptoms and causes is endless. But, in any case, this is a good reason to go to the doctor in order to prevent more serious consequences.
Pain in the perineum when sitting
Infringement of the pudendal nerve is a rather painful phenomenon, especially when a person is sitting or walking. Pain in the perineum subsides in a standing position. Sometimes it seems to the patient that numbness has occurred on the inner side of the thigh. On this occasion, there are a lot of tips on the Internet, like: hot or cold compresses on the painful area. In no case, such manipulations should not be performed, because, nervous system man is the most unpredictable of all systems that he only has. Folk methods and alternative therapy are also not relevant. Only a qualified specialist (neurologist, neuropathologist, neurosurgeon) should deal with this problem.
A woman after childbirth in a sitting position may also experience pain in the perineum. Here, usually the pain goes away on its own with time, when the traumatic consequences completely disappear.
Itching and pain in the perineum
Pain in the perineum in combination with itching may mean that a person has a milkman or another fungal disease. On this stage development of medical technology thrush can be cured at home. Women are most often prescribed vaginal suppositories "Mikozhinaks", "Bifidin", "Acipact". In folk medicine, lime methods of douching: serum, soda solution (1 tablespoon of soda per glass of water), chamomile decoction.
For the treatment of candidiasis (thrush) in men, they resort to the following methods: Flucostat ointment, Fluconazole, Canephron dragee.
Itching and pain in the perineum are also characteristic of genital herpes. In addition, this disease has external flaws - the formation of herpetic sores on the genitals. His treatment is much more difficult. And sometimes genital herpes becomes chronic. Genital herpes should be treated under medical supervision. It is treated with such drugs:
- acyclovir,
- valacyclovir,
- famciclovir.
Also, pain and itching in the perineum are possible in case of an allergic reaction to underwear.
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