Vaginal Tears/Fissures

Posted by christatierney @christatierney, Sep 18, 2019

For some reason unknown to me, the interior of my vagina gets these small tears either randomly out of the blue or after sex. Not even my gynecologist is able to diagnose the problem as all my bacteria levels, PH, yeast, and over all vaginal health is normal. It is as if my vaginal lining is so thin and fragile. My boyfriend of 4 years is a champ (he is normal sized). Regularly we go 1-3 months without sex while the tears heal as sex can be painful with the tears present. Any diagnosis, things to help, similar experiences?! Help!!

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hi Christa, im sorry to hear that. Sounds very painful. I don't think i have ever experienced that, however I have had discomfort due to dryness. Do you get these even when using some type of lubricant like ky jelly?

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@christatierney- Welcome to Mayo Connect. We can't diagnose anyone's symptoms because we are ordinary citizens just like you. But we mentor based on our experiences and knowledge. As I am an older woman I have experienced this type of discomfort. Tears and fissures inside your vagina are very painful. After menopause, when estrogen is very very low, vaginal fluids are hard to come by. Dryness, as @olivia22819 mentioned, can be a huge culprit. Dryness doesn't necessarily mean that you are dry all of the time. It can come and go given what you do, eat or drink. So we women must help nature along. There are many products that can help. These can happen without having sex too. Do you have any wounds or injuries on the outside of your lady parts?
https://www.fairview.org/patient-education/116680EN
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800285/

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@christatierney - I wanted to welcome you to Mayo Clinic Connect. Glad you have connected with @olivia22819. I also wanted to introduce you to some other members who may have some thoughts for you - from their own experiences or otherwise - on the type of vaginal tears/fissures you are talking about occurring randomly or after sex. Please meet @baxtersmom @brightwings @lioness @mri8191 @dval @harper2018.

That is really rough that regularly you and your boyfriend have to go 1-3 months without sex while the tears heal. I imagine it must be frustrating that nothing has come up as diagnosable so far.

Curious also about what olivia22819 asked about whether these tears still happen if you use some type of lubricant? Have you considered getting a second opinion from another gyn on your situation?

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My experience has been more with an anal fissure from constipation issues. It has almost been a year and I am still trying to heal. There has bean much pain over this past year from all of this. But during this process and seeing doctors, I have learned that there is some special therapy for women who have pain with sex. The thought behind it is that the pelvic floor muscles are not relaxing as they should and they are staying too taunt. For me, my pelvic floor muscle issue is more related to spinal stenosis which is a narrowing of the spinal canal and a budging disc that is pressing on my spinal cord. In this special therapy there are some things to do to try and help stretch the vaginal muscles and help them relax more as they should, when they should. This may not be your issue but food for thought. I had know idea about this therapy until I was introduced to it. I had no idea that there are way to relax muscles at some pressure point within your vagina. On a more personal thought and suggestion from past experience, maybe think about more foreplay with the sex as well as the types of foreplay along with the KY Jelly. This foreplay can be particularly important and helpful for the women in preparing their muscles around the vaginal area and personal lubrication. I also would not think about it as 3 months without sex. There are lots of ways to have sex without penetration. You just have to use other methods for the time being. I hope you find a solution. Sex should never be painful.

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Have you had a 2nd gyn check you out and get info from them I have had fissures but never vaginal tares . That has to be so frustrating . As a suggestion have you tried just Vaseline gel as a healing ointment ? What has the Dr. said to use . Don't let these just be dry I don't think the tares would heal keep them lubricated with something .

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Okay, I have just come from my special PT appointment. I asked my Therapist what to call this type of Therapy exactly and she said it is called, "Pelvic Floor Muscle Physical Therapy". She also wanted me to share her twitter which is @laurameihofer and you can google her or look at her YouTube site to learn more about all of this: https://www.youtube.com/channel/UCcTgM_qYmkZVMS1548I7eFA (google her via Laura Meihofer, LLC). She is excellent at explaining things and very helpful. I also talked to her about lubricants. I know @lioness suggested Vaseline gel but I want to caution you with that because Vaseline can cause infections in the vaginal area. The other Lubricants beside KY Jelly that you could use is Sliguid. Look for lubricants that are water based, Silicone base, or hybrid of those. I typed in Sliquid and a few CVS things popped up so maybe you can review a few of those if KY Jelly is not something you are interested in. I also learned that some people can get a little dry and the friction can cause a sort of worn area like a rug burn especial where there becomes a fold in the tissue. In this instance it is not really a fissure but an area that has become sore and sensitive (just like your skin can get a rug burn and be a bit sore). if this continues to happen and does not heal properly, then yes the tissue can get a little more sensitive and easier to injure. These are just suggestions and food for thought. I would continue to consult with your doctor and if necessary get a second opinion. Their exam should provide more information and be able to diagnose this issue for you better. I had never heard of this type of Physical Therapy before myself until about 3 years ago. Even so I didn't really know that much about it until I was sent to it myself. Hope you find some helpful information in all of this. Take care and never stop searching for answers. You deserve it ! I know the right doctor can make a huge difference.

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I want to share that there is a difference between lubricants and moisturizers. Since menopause, I've experienced vaginal dryness and the tissues are very delicate. My gyn oncologist recommended a vaginal moisturizer (also advertised as a lubricant) that her other patients like. It's called "Gennveve" and on Amazon. I just started to use Gennveve so no report yet from me. There are also vaginal moisturizers you can buy over-the-counter like Replens. These moisturizers are applied a few times a week. Lubricants are used during sex (think Astroglide).

I concur with others here that getting opinions from from other gynecologists is key. Do you have Sirius radio? I do not usually recommend any media-based medical show, but I like to listen to Dr. Miriam Green on the Sexual Health show. Her recommendations are thoughtful based on her experiences with patients and the published science in peer-reviewed journals.

Happy to hear that your boyfriend is very patient and supportive. This is so important and says volumes about your relationship.

I am hoping you will find the help you need in the medical community. You came to right place for support here at Mayo Clinic. The mentors and posters have been so caring and supportive to me.

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@mri8191

Okay, I have just come from my special PT appointment. I asked my Therapist what to call this type of Therapy exactly and she said it is called, "Pelvic Floor Muscle Physical Therapy". She also wanted me to share her twitter which is @laurameihofer and you can google her or look at her YouTube site to learn more about all of this: https://www.youtube.com/channel/UCcTgM_qYmkZVMS1548I7eFA (google her via Laura Meihofer, LLC). She is excellent at explaining things and very helpful. I also talked to her about lubricants. I know @lioness suggested Vaseline gel but I want to caution you with that because Vaseline can cause infections in the vaginal area. The other Lubricants beside KY Jelly that you could use is Sliguid. Look for lubricants that are water based, Silicone base, or hybrid of those. I typed in Sliquid and a few CVS things popped up so maybe you can review a few of those if KY Jelly is not something you are interested in. I also learned that some people can get a little dry and the friction can cause a sort of worn area like a rug burn especial where there becomes a fold in the tissue. In this instance it is not really a fissure but an area that has become sore and sensitive (just like your skin can get a rug burn and be a bit sore). if this continues to happen and does not heal properly, then yes the tissue can get a little more sensitive and easier to injure. These are just suggestions and food for thought. I would continue to consult with your doctor and if necessary get a second opinion. Their exam should provide more information and be able to diagnose this issue for you better. I had never heard of this type of Physical Therapy before myself until about 3 years ago. Even so I didn't really know that much about it until I was sent to it myself. Hope you find some helpful information in all of this. Take care and never stop searching for answers. You deserve it ! I know the right doctor can make a huge difference.

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How is the pelvic floor therapy going for you, @mri8191? I think I'm in the minority, but I "failed" that type of PT! I would move the wrong muscles or move them the wrong way (e.g., in, instead of out) a lot, not on purpose. What an odd place to be uncoordinated, but that was the case with me.

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@lisalucier

How is the pelvic floor therapy going for you, @mri8191? I think I'm in the minority, but I "failed" that type of PT! I would move the wrong muscles or move them the wrong way (e.g., in, instead of out) a lot, not on purpose. What an odd place to be uncoordinated, but that was the case with me.

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@lisalucier It took me a number of sessions before I was doing it the right way but I did manage to eventually. It's not as easy as you would think it would be.
JK

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My Dr. said I need estrogen so am using inserts although I am not thrilled about it as I have a family history of breast cancer.
Best wishes
Ainsleigh

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