What Is the Perineum?

The perineum is the small but important area of tissue located between the genitals and the anus. It supports several pelvic structures and serves as a major point of muscle attachment. Because of its close connection to nerves, muscles, and organs in the pelvis, discomfort in this region is common.

What Is Perineum Pain?

Perineum pain refers to tenderness, burning, pressure, or aching in the tissue between the genitals and the anus. This discomfort can affect people of any gender and may stem from irritation, inflammation, injury, or underlying pelvic conditions. Pain may be felt directly in the perineum or radiate from nearby structures, such as the pelvic floor, bladder, rectum, or reproductive organs.

Who Is Affected by Perineum Pain?

Anyone can experience perineum pain. It can be caused by injury, infection, strained pelvic muscles, digestive issues, or systemic conditions such as diabetes. Symptoms may occur suddenly or develop over time and can affect individuals of any age.

Perineum Pain in Men

In men, the perineum is the area between the scrotum and the anus. Irritation in this region may be linked to prostate inflammation, infections, tense pelvic muscles, or urinary tract issues. When the prostate becomes swollen or inflamed, pressure on surrounding nerves can cause burning, aching, or sharp perineal pain. Some men also report pain that worsens with sitting, bowel movements, or ejaculation.

Perineum Pain in Women

In women, the perineum lies between the vaginal opening and the anus. Women may experience perineum pain due to urinary tract infections, pelvic floor strain, digestive irritation, or reproductive health issues. This area is also prone to stretching and tearing during childbirth, which can lead to soreness, itching, swelling, or painful intercourse while healing. Hormonal changes and chronic pelvic pain conditions can further contribute to discomfort.

Signs and Symptoms

Common perineum pain symptoms across genders include:

• Burning or stinging sensations.
• Lower abdominal or pelvic pain.
• Genital or anal pain.
• Lower back discomfort.
• Pain that worsens with sitting.

Additional symptoms in women may include vaginal discharge, painful urination, soreness, itching, or pain during intercourse or orgasm. Additional symptoms in men may include bladder pressure, frequent urination, tailbone pain, and discomfort during ejaculation.

What Causes Perineum Pain?

The cause of perineum pain can differ between men and women. However, many causes are the same across genders. Pain often comes from nearby organs, pelvic muscles, or nerves that become irritated or inflamed.

All Sexes

The following conditions can cause perineum pain in men and women:

• Injuries — Minor injuries to the groin can cause perineum pain. Injuries can occur from falls, accidents, or strikes to the groin.
• Pelvic floor dysfunction — Pelvic floor dysfunction happens when your pelvic muscles are not working properly. Experts are not entirely sure why this happens, but it may be caused by stretched or weakened muscles from childbirth, pelvic surgery, or chronic straining.
• Hemorrhoids — Hemorrhoids are varicose veins in the anus or rectum. They usually develop because of increased pressure and straining while passing stool, pregnancy, or heavy lifting, and can cause discomfort that radiates to the perineum.
• Interstitial cystitis — Interstitial cystitis is a long-lasting condition that causes pressure and pain in your bladder. Because pelvic nerves overlap, this discomfort can be felt in the perineum even when the bladder is not full.
• Pudendal nerve entrapment — This occurs when surrounding muscle or tissue compresses the pudendal nerve. Irritation of this nerve can cause burning, aching, or sharp pain in the perineum.
• Abscess — An abscess is an infected pocket of pus. An abscess can form on your perineum or in a nearby area, causing swelling, redness, and pain.
• Urinary Tract Infections (UTIs) — UTIs develop when bacteria enter your urinary system through the urethra. Most UTIs affect the lower urinary tract and can cause pressure or pain that radiates to the perineum.

Causes in Men

Prostatitis can also cause perineum pain in men. Prostatitis is pain and inflammation of the prostate gland. It can be acute or chronic, but it is usually temporary and may resolve within several weeks to months. Men may experience mild discomfort or severe pain, often worsening at night.

Other symptoms may include difficulty urinating (such as dribbling urine), painful ejaculation or orgasm, pelvic pressure, and waking frequently at night to urinate. When the prostate becomes swollen, it can place pressure on nearby nerves, contributing to perineum pain.

Causes in Women

There are several causes of perineum pain specific to females:

• Childbirth — Childbirth can stretch or tear the perineum, which may lead to pain during healing. During labor, an episiotomy (a small incision in the perineum) may be performed to help the baby pass through the birth canal, which also contributes to postpartum soreness.
• Vulvodynia — Vulvodynia is chronic pain in the vulva (including the clitoris and labia) without an obvious cause. This pain can sometimes spread to the perineum. Irritation from sexual intercourse, friction, or tight clothing may worsen symptoms.

Diagnosing Perineum Pain

Perineum pain diagnoses involve a routine medical exam, a discussion of your symptoms, and other tests based on what your provider suspects. Because there are many possible reasons for perineum pain in men and women, your provider may use several evaluation methods.

Common diagnostic tests include:

• Blood tests — These can show signs of infection, inflammation, or other conditions that may be causing pain.
• Urinalysis — A urinalysis helps detect urinary tract infections or blood in the urine.
• Radiological evaluation or ultrasound — Imaging tests help identify abnormalities such as cysts, tumors, masses, or structural changes in the pelvic region.

Treatment

Perineum pain treatment varies based on the underlying condition causing the pain.

• Rest — Rest allows the body to repair irritated or strained tissues.
• Antibiotics — Certain types of perineum pain caused by bacterial infections may improve with prescribed antibiotics.
• Perineal massage — This is a type of physical therapy that helps relax and stretch pelvic muscles. It should be postponed until inflammation decreases. Perineal massage can help with pain from hemorrhoids, constipation, perineum tearing, anal fissures, and some pelvic floor conditions.
• Perineal pads — Also called sanitary pads, these may be used after childbirth, during healing from perineal injury, or to protect clothing from bleeding or drainage.

Your healthcare provider will determine the most appropriate treatment based on your symptoms and medical history.

FAQ

How to soothe irritated perineum?

A warm sitz bath, gentle cleansing, and avoiding tight clothing may help reduce irritation. Cold or warm compresses and over-the-counter pain relievers may also provide comfort. If symptoms do not improve, contact a healthcare provider.

When should I see a doctor about perineum pain?

You should see a doctor if the pain is severe, does not improve within a few days, or is accompanied by fever, swelling, discharge, or difficulty urinating. Sudden or worsening pain should be evaluated right away.

What type of doctor treats perineum pain?

Primary care providers, gynecologists, urologists, and pelvic floor specialists commonly diagnose and treat perineum pain. Your provider can help determine which specialist is most appropriate based on your symptoms.