The perineum hurts a lot. Treatment of inflammation and nagging pain in the perineum in men. Pain when performing various activities

Pain in the perineal area in males can often occur due to the fact that they have a predisposition to inflammatory pathologies of the urinary system, such as inflammation of the seminal sacs, urethritis, various diseases of the prostate gland, and so on. Sometimes the main causes of pain and itchy burning in the male perineum are factors such as hypothermia, sexually transmitted diseases, as well as complicated forms of cystitis and urethritis. Pain in the perineal area can be aching, sharp, itchy, pulling, twitching, pulsating.

The appearance of sharp pain in the perineum

Lower abdominal pain

Acute, sharp pain in the perineal area in males is often associated with inflammation of the prostate gland. This pathology is accompanied by negative symptoms. Pain can be felt in the penis, anus, its ring, and sacrum. Pathologies of the urethral canals are common causes of severe pain. When a man gets rid of the fluid that accumulates in the urethra, it significantly increases the pain and itching.

Also, sharp pain in the perineum in men can be one of the symptoms of a purulent formation in the prostate area. It can radiate through the rectum and sacral area. This disease is characterized by its unilateral location, that is, pain on the side where the purulent focus is localized. Men complement this “bouquet” with impaired stool rejection and urinary emission. The temperature is noticeably increased, which causes a negative regression of the central nervous system.

Severe burning in the perineum in men can be accompanied by late-stage prostate cancer. In this case, only narcotic drugs can anesthetize the inflamed area. One of the causes of sudden onset pain may be pinched genital nerves. Only during sleep can a man get rid of pain for a short time. The latter tend to intensify when walking, lying down, and sitting. When any of the nerves are pinched, there is a feeling of numbness in the hip.

A strong sharp pain point in the male perineum occurs with any injury:

Perineal pain

• hematoma formations;
• severe bruises;
• gunshot wounds;
• subcutaneous muscle tears;
• stab wounds.

Since multiple nerve endings are concentrated in the perineal region in men, with various types of traumatic bruises they can lose consciousness from excessive pain in the groin area.

Aching and nagging 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 pain is not so severe, but tends to be long-lasting, in some cases permanent. Prolonged itching in the perineum in men and general discomfort increases when men use a hygienic toilet. In this situation, this is due to the fact that inflammatory processes in the area of ​​the urethral-bulb glands, that is, cooperitis, are possible. The disease tends to arise from inflammation of the urethral canals. During the pathology of cooperitis, suppuration of the area of ​​inflammatory processes may intensify.

It is also necessary to remember that pathologies of the urinary tract in men are not necessarily accompanied by pain or itching of the perineal area.

Urologists add factors to this list:

• various pathologies of the rectum: fissure, tumor, paraproctitis, hemorrhoidal manifestations;
• neuralgic pathology, which may include injury to the nerve trunk, disruption of the coccygeal-sacral parts of the vertebral parts;
• adhesions in the pelvic areas that appeared after surgical interventions or inflammatory processes;
• psychosomatic pain;
• muscle spasm;
• various pathologies of the hip joint.

Males associate pain in the perineum with various inflammatory processes in the prostate and groin area. Such pathologies are accompanied by severe 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, radiating to the perineum. Such patients are prescribed therapy, which is aimed at stopping the patient from itching.

Causes of itching in the perineum

When pain is accompanied by itching in males, there can be many reasons, but the main ones are considered to be various fungal diseases, often such as thrush. Itching and 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, and diseases of the urethra.

Itches under the testicles

Burning and itching sensations are caused by almost everything, even cheap underwear containing synthetic materials. Wearing such underwear tends to cause allergic reactions and 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 cause trouble to your reproductive system, and also not to cause pelvic diseases.

Painful sensations with pain moving to the groin

Various pathogenesis of the perineum tends to spread to the groin area. There are a large number of factors that force men to exhibit all the negative symptoms. Often, such a painful sensation appears in males, who, to the extent of their professionalism, are associated with systematic physical overexertion. This is precisely the reason that groin and perineal pain bothers a global number of athletes and bodybuilders of various levels.

The most common manifestations of such symptoms can be defined as:

Discomfort in the groin

• The formation of hernias (prolapse from the peritoneum under the skin of the organ) - occurs due to weakening of the abdominal tissue due to excessive physical activity. In order to diagnose this disease, no serious studies and tests are often carried out; a hernia is detected during a routine examination of a person. If the hernia is hidden far under the tissue, the person is prescribed palpation. One of the traditional diagnostic methods for detecting hernias is a common cough. When a person coughs, a pulling sensation is felt under the navel.
• One of the common causes of pain in the perineum and groin areas is the inflammatory process of the pelvic organs. Such pain manifests itself due to an increase in infection in the body. By infecting pathogenic microorganisms, the lymph nodes begin to grow, causing wild, nagging pain.
• Unpleasant sensations in the groin and perineum in males occur due to the formation of kidney stones, especially when the stones are located extremely low or have already penetrated the urethra.
• Pain may appear with osteochondrosis of the lumbar vertebra. When a person discovers that he has a similar pathology, he discovers that in the event of a complication, the disc part of the vertebra can compress one of the many nerve endings. Therefore, sharp and acute pain occurs in the groin area.

If a burning sensation and pain in the perineal part make themselves felt when the body rejects fluid from the urethra, there is an urgent need to take a test for prostate-specific antigen. In this way, you can check for the presence of inflammatory processes in the body, indicating pathologies associated with disorders of the prostate glands, urethral canals, and colliculitis.

The situation when a man has pain between his legs is quite unpleasant. Most often, pain in the perineum is caused by inflammatory diseases of the genitourinary system. But also causes of discomfort can be hypothermia or non-infectious pathologies (for example, hemorrhoids, appendicitis).

Have you had a full medical examination in the last 5 years?

YesNo

Such symptoms indicate diabetes mellitus, liver cirrhosis, hepatitis and other dangerous disorders.

Injuries

Sharp pain appears after mechanical damage. These include:

They occur during impacts, accidents, industrial damage, or during sudden, inaccurate friction during sexual intercourse or masturbation. A long period of persistent pain after surgery signals the development of complications.

Diseases of the genitourinary system

Cutting pain in the perineum in men when walking indicates the presence of kidney stones. Their intensity increases when foreign matter enters the urethra. Discomfort is provoked by inflammatory processes of the pelvic organs, which are often caused by infections.

Prostatitis

Acute prostatitis is characterized by sharp pain in the perineum, aggravated by urination. They often radiate to the penis, anus, rectum and sacrum. Signs of a viral infection appear:

With chronic prostatitis, the pain is not so severe, but it can increase with erection, ejaculation, stress, hypothermia, and consumption of large doses of alcohol. If the cause of the development of prostate inflammation is infection, then it is observed. Non-infectious prostatitis can be identified by the localization of discomfort in the pelvic area. The pain is aching, vague, periodically disappearing and appearing again. Constant unbearable pain may be a sign of prostate cancer.

Sexually transmitted infections

Painful sensations are often accompanied by itching, burning during urination, discharge, and various types of rashes. Common infections are:

• genital herpes. A burning sensation occurs after spontaneous opening;
• gonorrhea. Burning and itching intensify when trying to relieve a small need. At the end of the process, blood is released.
• trichomoniasis. The pain is felt both during urination and during sexual intercourse. Discomfort in the perineum, testicles, and scrotum gradually develops. There is pain during defecation;
• chlamydia. A burning sensation in the urethra bothers me after ejaculation. Microbes can infect the prostate gland, so it is possible that symptoms of prostatitis may occur;
• urethritis. With inflammation of the urethra, pain and burning occur when urinating.

It is necessary to exclude abscess, adenoma and cysts of the prostate, orchitis, cysts of the testicle and spermatic cord, vesiculitis and many other pathologies that cause pain in the perineum in men.

Nervous system disorders

Pain from the perineum can radiate to the groin area. This symptom is encountered by men whose professional activities involve heavy stress. Discomfort worries athletes, loaders, and drivers. Due to weakness of the abdominal muscles, an inguinal hernia may emerge, which is clearly visible in a standing position. The protrusion of internal organs is easy to palpate independently. The main symptom of a hernia is reduction inward with light pressure. Acute pain is often caused by a pinched organ, which can only be corrected through surgery.

Osteochondrosis of the lumbar region

A disease characterized by disturbances in the structure of cartilage and bone tissue. It makes itself felt with severe back pain or a slight feeling of discomfort. Often, the vertebral discs compress the nerve endings of the spinal cord, which causes acute pain in the perineum.

Pinched pudendal nerve

Severe paroxysmal pain and burning in the perineum in men when sitting and lying down is localized in the pelvis. The discomfort subsides if the person stands quietly. Pain increases with physical activity. In this case, numbness of local areas of the thigh is observed.

It is important to remember that pain, burning and any other unpleasant sensations signal problems in the body. Therefore, if discomfort occurs, you should contact a urologist for an examination and tests. It is possible that you will have to visit a proctologist, neurologist, oncologist and dermatologist to make an accurate diagnosis. If you listen to your body in time, you will be able to avoid many complications.

Is a weak stream of urine in men normal or an alarm bell? What can cause tailbone pain in men? What usually hurts in the left side of men?

The perineum is a set of pelvic floor muscles that closes the exit from the pelvis. The perineal area is located between the anus and the posterior edge of the vaginal opening in women, and the edge of the scrotum in men. The perineal area in a woman includes the urinary tract, anus and vagina.

A woman may experience such unpleasant sensations in the perineum as itching, burning of the perineum, fissure, feeling of fullness, pressure, sharp or aching pain. There are many pathological changes in the body that cause these symptoms. Also, discomfort in the perineal area in certain cases may be normal.

1. Pregnancy

During pregnancy of up to 20 weeks, discomfort in a woman's perineum should be an alarming factor, as it may signal the possibility of miscarriage. Especially if the discomfort is accompanied by bloody discharge. During this period, the fetus is still very small and its movements are in no way perceptible to the woman. Therefore, any mechanical impact of the fetus on the perineal area is excluded.

After 20 weeks, the baby in the womb grows and develops rapidly. The mobility of the arms and legs becomes more active and stronger. The baby's movements most often cause short-term, acute, but not severe pain, a feeling of pressure in the perineum.

As the happy moment of childbirth approaches, discomfort in the perineal area may intensify significantly. The reason is the fairly large volume and weight of the fetus, which puts pressure on the woman’s internal organs, muscles and bones. Heaviness in the perineal area is especially aggravated in the last days before childbirth, which is due to the expansion of the pelvic bones. This process is provided by nature to facilitate childbirth, both for the baby and for the mother.

Due to the growth of the fetus, pinching of the sciatic nerve can occur, which often causes severe pain. Doctors recommend that you endure this discomfort without treatment. After childbirth everything returns to normal.

1. Birth injuries of varying degrees

The most common cause of discomfort in the perineum in women is postpartum trauma:

• external ruptures of the perineal tissue during the passage of the child’s head through the birth canal. The reason for this may be insufficient elasticity of the perineal muscles or very rapid labor. Hygienic procedures, urination is accompanied by a burning sensation in the perineum.
• forced incisions of the perineal muscles during delivery are carried out by a doctor to prevent rupture and facilitate wound healing in the future.
• internal ruptures of the cervix or vaginal muscles. This problem occurs more often in primiparous women. The dilatation of the cervix takes longer for them, and the vaginal muscles are inelastic. Pushing may begin with incomplete dilation, which results in tears and cracks in the tissues, causing pain and burning throughout the perineal area.

Doctors recommend starting sexual activity 2 months after a complicated birth. Resuming intimate relations with a partner earlier can cause infection in unhealed wounds. This leads to relapse of inflammation of the perineal tissue.

A woman who has given birth may experience discomfort, a burning sensation and discomfort for some time until the wounds are completely healed and the stretched muscles and ligaments are restored. During the normal course of this process, the inflammation of the perineum goes away.

1. Infectious and inflammatory diseases

Itching, burning, and discomfort in the perineum of women can be caused by the following inflammatory diseases:

• colpitis (vaginitis) - inflammation of the vaginal walls is accompanied by pathologically strong discharge and stabbing pain, burning both in the perineum and in the vagina itself.
• bartholinitis is an inflammation of the glands located at the entrance to the vagina and providing its lubrication. Inflamed and swollen tissues of individual areas of the perineum block the secretion of the glands, which causes stagnation and the formation of pus. The infection spreads to the gland itself, and an abscess forms. A burning sensation in the perineum due to inflammation of the Bartholin glands occurs when walking, when passing feces, during sexual intercourse and subsides several hours after intercourse. All these symptoms are accompanied by fever. Interestingly, an abscess can open on its own without treatment. This often leads to recovery.
• inflammation and fissures of the rectum are accompanied in most cases by diseases of the gastrointestinal tract. The consequence of this is irregular stool (diarrhea or constipation), due to which the excretory passage is injured, there is acute pain and burning in the perineum. Treatment of rectal fissures primarily involves diagnosing and treating the underlying disease. To relieve symptoms, relieve inflammation, and eliminate discomfort, suppositories and laxatives that dilute stool are prescribed.
• genital herpes causes characteristic rashes on the genitals. The rash consists of blisters filled with liquid that burst after a while. The ulcers formed in the perineum after this heal, becoming covered with crusts. As the disease progresses, a burning sensation in the perineum and area of ​​the rash and severe itching are observed.

1. Chronic pelvic pain

It is important to pay special attention to the fact that this syndrome is a symptom of a number of diseases and is accompanied not only by discomfort in the perineum of women, but also causes pain in the buttocks, lower back, and lower abdomen. The presence of the syndrome is a good reason to consult a doctor to find out the true reasons, which may be:

• diseases of the gastrointestinal tract;
• diseases of the genitourinary system;
• disorders and pathologies of the structure and articulation of the pelvic bones;
• tumors;
• depressive state after suffering violence, severe stress.

1. Pinched pudendal nerve (neuropathy)

The pudendal (pudendal) nerve is located in the perineum and provides communication between the organs and tissues of the pelvis and the central nervous system. Its pinching causes an unexpected sharp pain in the perineum when walking, sitting or lying down. At rest it disappears. When the pudendal nerve is pinched, the pain can spread to the inner surface of the thighs and be accompanied by numbness; sometimes there is numbness of the genitals, a deceptive feeling of discomfort and the presence of a foreign body in the rectum or vagina. Urinary incontinence may occur.

Diagnosis of the disease is carried out by blocking the pudendal nerve. The final diagnosis is made if, after the procedure, pain symptoms in the perineum decrease and the patient’s general condition improves. Treatment is medication. If it is ineffective, surgical intervention must be resorted to.

1. Skin diseases

Skin diseases of the perineum include fungus. The disease causes severe itching and burning in the affected area. It appears in the initial stages in the form of red spots with a clear boundary. The disease often develops due to non-compliance with personal hygiene rules. Elementarily, a person suffering from mycosis of the feet can transfer the infection with his own hands or a towel to the groin area.

Interesting video:

Perineal fungus can develop in very obese people. Existing disorders in the functioning of the pancreas and thyroid glands are also the cause of fungal infection.

Interestingly, a fungal infection of the perineum can go away on its own without special treatment.

WHO SAID THAT IT IS HARD TO CURE INFERTILITY?

• Have you been wanting to conceive a child for a long time?
• Many methods have been tried, but nothing helps...
• Diagnosed with thin endometrium...
• In addition, for some reason the recommended medications are not effective in your case...
• And now you are ready to take advantage of any opportunity that will give you the long-awaited baby!

The perineum is the area between the anus (anus) and the external genitalia, these are soft formations, fascia and muscles located between the bones of the pubis, the upper part of the tailbone and the ischial tuberosities. The perineum in men and women differs little in shape and is diamond-shaped, but in size the perineum in men is longer. In women, the perineum serves as a support for the pelvic organs, forming the pelvic floor.

Causes of pain in the perineum

Pain in the perineum can be constant or short-term, situational, occurring in certain circumstances, for example, during sexual intercourse or during bowel movements. Pain in the perineal area can be acute, aching or completely unnoticeable.

Often pain syndromes can spread to the lower abdomen, to the tailbone or pubic area. The causes of pain in this area may be the following: changes in the hormonal levels of the body, hypothermia of the body with a weakened immune system, prolonged or uncontrolled use of certain medications, for example, antibiotics, and sexually transmitted infections.

Pain can occur during an exacerbation of prostatitis and be so strong and acute that it radiates to the sacrum or head of the penis. Chronic prostatitis occurs with less pronounced but more prolonged pain. Sharp and severe pain in the perineum may be a manifestation of a prostate abscess.

Of course, any pain in the perineum that occurs should be a reason for immediate contact with a specialist in order to promptly determine the cause of the pain and get rid of it. If pain occurs in the perineum, abdomen, groin, penis, burning and cutting in the urethra, or characteristic discharge from the genital tract, men should consult a urologist, and women should consult a gynecologist.

Doctors will prescribe further examination: ultrasound examination (ultrasound), smears from the urethra and vagina, and prescribe comprehensive treatment. If the symptoms are neglected, the disease can quickly become chronic, which is treated with great time and financial costs.

Perineal pain in men

The first and most common cause of pain in the perineal area is inflammation of the prostate gland. This disease mainly occurs in middle-aged men.

The reasons for its occurrence include:

• repeated hypothermia of the body and, as a result, weakening of the immune system;
• various infections and inflammations of the genitourinary system;
• long-term use of antibiotics without consultation with a doctor.

With this disease, pain is typically localized in the perineum and rectum.

Acute urethritis can also cause pain in the perineum in men. With the above disease, the pain is acute and painful; in its chronic form, it is not so strong and is similar to a burning sensation. The pain that occurs during urethritis is localized in the perineum.

Other causes of pain in the perineum include: traumatic injuries to the urethra and prostate gland, resulting from fractures of the pelvic bones, bruises, wounds, falls, and operations on the prostate gland; pinching of the pudendal nerve, which is a consequence of prolonged sitting or cycling; prostate cancer.

Pain in the perineum in women

In women, pain in the perineal area can be observed in the following cases:

• colpitis;
• bartholinitis;
• perineal injuries;
• pregnancy.

Pain in the perineum can be observed with diseases of the rectum - its inflammation, hemorrhoids, fissures. Pain syndrome in this area appears with furunculosis, herpetic eruptions, and papillomatosis in the anogenital area.

In some cases, chronic pelvic pain syndrome occurs, the causes of which remain unclear. Treatment in this case is aimed at correcting the symptoms of the disease. If pain of any nature or intensity appears in the perineum, you should immediately consult a doctor.

Pain in the perineum during pregnancy

Mostly, pain in the perineum during pregnancy appears after the thirty-fifth week of pregnancy. And this is normal, because such pains are harbingers of an imminent delivery. What happens in the body? The child begins to move forward little by little (the stomach drops), thus putting pressure on the nerve endings, muscles and ligaments, which causes pain.

In addition, the pelvic bones continue to diverge, preparing a place for the passage of the child, and the ligaments do not keep up with them, which can also cause pulling or shooting pain in this area. The perineum often hurts during pregnancy due to pinching of the sciatic nerve. In this case, the woman experiences discomfort in any position.

It is difficult for her to get out of bed or roll over to the other side or take a sitting position. The pain may worsen when walking. Unfortunately or fortunately, doctors do not prescribe treatment in this case, but rather advise waiting until it goes away on its own. The only exception is unbearable pain, which can be caused by a cold or inflamed nerve. In any case, consulting a doctor will not be superfluous.

If the perineum hurts during pregnancy in the earlier stages, you should definitely consult a gynecologist. After all, such pain may indicate a threat of miscarriage, and therefore it is better to be safe.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Introduction

Since the perineum is the location of the external genitalia, 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:

• acute 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 trauma (including trauma during childbirth);
• pregnancy;
• pinched pudendal nerve;
• prostate abscess;
• prostate cancer;
• skin diseases: boils, condylomas, 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 pain

Sharp, acute pain in the perineal area in men is most often associated with acute prostatitis. With this disease, pain can radiate to the sacrum, to the head of the penis, to the anus. Acute urethritis also causes severe, sharp pain. This pain intensifies when urinating.

Sudden, sharp pain in the perineum is characteristic of pinched pudendal nerve. This pain is slightly reduced if the patient stands quietly. When walking, as well as in sitting and lying positions, the pain intensifies. A pinched nerve can cause a feeling of numbness in an area of ​​the inner thigh.

In some cases, sharp pain in the perineum may occur in pregnant women (see below).

Severe, sharp pain occurs with any perineal injury:

• subcutaneous muscle ruptures;
• gunshot wounds or wounds inflicted by knives.

Since the mass of nerve endings is concentrated in the perineal area, pain during injury can be so severe that the patient faints.

Drawing, aching pain

Pain of this nature occurs in the perineum with chronic prostatitis, chronic urethritis, colliculitis (inflammation of the seminal tubercle in men). Often, pain in these diseases is described by patients as a burning sensation in the perineum. These pains, although not too intense, can be long-lasting 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 with cooperitis can sharply intensify if suppuration of the gland develops.

Postpartum pain in the perineum, associated with swelling and stretching of the birth canal, can also be aching.

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 pain in the vagina itself, and with copious discharge from it.

Pregnant women may experience stabbing, rather intense pain in the perineum shortly before giving birth.

Perineal pain 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 onion-urethral gland (cooperitis).

Perineal pain may be accompanied by a mysterious syndrome called chronic pelvic pain. 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 prescribed symptomatic treatment.

Pain in the perineum in women

In addition to vaginal diseases and chronic pelvic pain syndrome, discomfort and pain in the perineal area are often observed in women during pregnancy.

During pregnancy

Pain in the perineum most often appears in pregnant women after the 35th week of pregnancy, when the growing fetus begins to descend, putting pressure on all surrounding tissues (nerves, muscles, ligaments). It is when the ligaments are sprained that a woman experiences stabbing pain 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 takes such a position that it compresses a nearby nerve (for example, the sciatic). At the same time, the woman experiences a sharp pain that makes all movements difficult and does not subside even with 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 painful sensations, described as a burning sensation, 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 painful itching and burning in the perineal area. In addition to an allergic skin reaction, 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. Women in the postpartum period experience such pain when urinating, if during childbirth there was a rupture of the perineum and stitches were placed.

When walking

Pain in the perineum, which occurs or intensifies when walking, is felt by people with injuries to the coccyx (bruises, fractures). In men, difficulty walking, combined with pain in the perineum, occurs with inflammation of the testicles (orchitis) or their appendages (epididymitis), or with hydrocele.

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 pain is not too intense, decreases when walking and intensifies when standing still. The duration of pain is several minutes, maximum – several hours. Then it disappears spontaneously.

Prostatitis can sometimes cause pain in the perineum during sexual 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 lubricant. The pain with bartholinitis is pulsating in nature and continues for several hours after sexual intercourse, then subsides.

Men with complaints of pain in the perineum should initially consult a urologist or proctologist. You may need help from 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 men and women have a number of identical organs in the pelvis (intestines, bladder, etc.), as well as a number of completely different genital organs, the causes of pain in the perineum can be both diseases common to men and women, and specific ones 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 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 see the same doctors if they have pain in the perineum, since the pain syndrome is caused by the pathology of organs present in both sexes?
2. In what cases should women and men contact doctors of different specialties for pain in the perineum, since the pain syndrome is caused by pathology of organs specific to the male or female sex.

So, women and men should contact doctors of the same specialty if pain in the perineum, together with other symptoms, indicates urethritis, perineal trauma, pinched pudendal nerve, boils, papillomas or condylomas in the perineal area, hemorrhoids, rectal fissures, proctitis, paraproctitis, allergic reactions, coccyx injuries.

If an injury has been caused to the perineum (bruise, blow, wound, rupture, etc.), then a sharp and very severe pain occurs. In such a situation, you should immediately call an ambulance and be hospitalized, since if the perineum is injured, various organs and tissues can be damaged so severely that without qualified medical care the person will die.

If pain in the perineum periodically occurs in a person some time after an 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 man has a boil or growth of condylomas/papillomas in the perineal area, then you should contact Dermatologist (make an appointment) to diagnose them, and then to a surgeon to remove them.

If a man or woman has sharp, sharp pain in the perineum, also felt in the coccyx, intensifies when walking and weakens when standing, appears after a traumatic impact on the coccyx area (for example, a blow, a fall, etc.), then this indicates coccyx injury. In this case, you should contact traumatologist (make an appointment) or a surgeon.

If a man or woman experiences pain in the perineal area, felt on the skin, and not deep in the tissues, combined with severe itching and swelling, and possibly rashes on the skin, then this indicates an allergic reaction, and in this case, you should speak to Allergist (make an appointment) and a dermatologist. A dermatologist should examine the skin to rule out the presence of any serious disease and confirm the allergic nature of the pain and pathological changes in the skin.

If a woman or man experiences severe pain and burning in the perineum when urinating, which is combined with frequent urge to urinate, urine mixed with turbidity and 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 a burning sensation, severe sensitivity and the sensation of a foreign body in the pelvic organs, and also causes numbness along the inner surface of the thigh, intensifies when walking, in sitting and lying positions, does not decrease with time, this indicates a pinched pudendal nerve, and in this case it is necessary to contact neurologist (make an appointment).

When pain in the perineal area in a man or woman is combined with pain in the anus or rectum, discomfort during bowel movements, possibly with discharge 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 those described above, men and women who experience pain in the perineum should contact doctors of various specialties, since pain is provoked by diseases of specific genital organs.

When perineal pain 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 genitals (greenish, white, lumpy, etc.) or rashes in the area of ​​the external genitalia (pubes, labia, penis, etc.), then this is about sexual infection (sign up) (genital herpes (sign up), candidiasis), and in this case, representatives of both sexes can contact venereologist (make an appointment) and, in addition, women should see a gynecologist, and men should see a urologist.

If pain in the perineum is combined with pain in the lower abdomen that does not have a clear localization, occurs periodically, goes away on its own, does not intensify over time, and is not combined with any other symptoms of the genital organs (inflammatory discharge, rashes, itching, bleeding and etc.), then chronic pelvic pain syndrome is suspected, and in this case women should consult a gynecologist, and men should consult a urologist or andrologist (make an appointment).

If in men pain in the perineum radiates or is simultaneously felt in the lower abdomen, in the rectum, combined with pain in the testicle, enlarged scrotum, sensation of a foreign object in the rectum, poor health, possibly with difficulty, frequent or painful urination, elevated body temperature, intensified 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 nagging, bursting pain in the perineum after sex, which is also felt in the testicles, combined with discomfort, heaviness and visible veins of the scrotum, intensifies when walking, spontaneously disappears after a few hours, then a varicocele is suspected, and in this case it is necessary to contact surgeon

If a man develops a nagging, aching pain or burning sensation in the perineum, which is present almost constantly, intensifying in a sitting position and during defecation, inflammation of the onion-urethral gland (cooperitis) or the seminal tubercle (colliculitis) is suspected. In this case, you need to contact a urologist or andrologist.

If a woman experiences pain in the perineum, combined with itching, burning, pain and abnormal vaginal discharge, and all symptoms worsen with urination, vaginitis is suspected. In this case, you need to contact a gynecologist.

If a woman experiences 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 by various diseases, and therefore, if this symptom is present, the doctor can prescribe various tests and examinations, a specific list of which is determined by the accompanying symptoms, which makes it possible to suspect a pathological process and the organ affected by it. Therefore, it is obvious that the choice of prescriptions is determined by the doctor based on all the clinical symptoms that allow him to make a preliminary diagnosis, and then confirm or refute it with the help of examinations. Let's consider what tests and examinations a 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, the doctor will prescribe Ultrasound (sign up) to assess the condition of the tissues and identify possible causes of pain. If ultrasound is not informative enough, it may be prescribed Magnetic resonance imaging (sign up). Further, if no serious diseases of the pelvic organs have been identified, therapy for post-traumatic syndrome is prescribed, aimed at the most complete tissue restoration. But if, during an ultrasound or tomography, diseases of the genital, urinary organs or intestines were identified, 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, the doctor may prescribe the following tests and examinations:

• General blood test (sign up);
• Bacteriological culture of the discharged boil;
• Testing blood or genital secretions for the presence of human papillomavirus (PCR or ELISA) (sign up).

When a man or woman has a boil in the perineum, the doctor usually prescribes only a general blood test to assess the condition of the body and culture of the discharged abscess to determine the pathogen that provoked the inflammatory process. Next, the boil is removed and an antibiotic is prescribed, to which the microorganism that caused the inflammation is sensitive.

When a man or woman has growths of papillomas or condylomas in the perineum, the doctor prescribes a blood and/or genital discharge test for the presence of the human papillomavirus in order to understand whether the process of their formation is chronic or due to a one-time decrease in immunity. If papillomas/condylomas appear as a result of decreased immunity, they are simply removed surgically and no specific treatment is prescribed. But if the process is chronic, then after removing 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 impact on the coccyx area (bruise, blow, etc.), sharp pain is felt simultaneously in the perineum and coccyx, intensifies when walking, weakens when standing, 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 distinguish a bruise from a fracture. If the doctor suspects that a coccyx injury has provoked the formation of an extensive hematoma in the soft tissues, then in addition to X-rays, he may prescribe magnetic resonance imaging.

When a representative of either sex experiences pain in the perineum, strongly felt from the outside and not deep into the tissues, combined with itching and swelling, and possibly also 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;
• Skin allergy tests using 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, ragweed, wormwood, pigweed white, plantain, Russian thistle, fragrant spikelet, perennial rye, timothy, cultivated rye, woolly milkweed, for house dust and house dust mites).

To identify the allergic nature of pain in the perineum, the doctor must prescribe a general blood test and any tests for hypersensitivity to allergens (or skin tests (sign up), or determining the concentration of specific IgE in the blood), as this is necessary to identify the substance that provokes a hypersensitivity reaction in humans. A test for the concentration of IgE in the blood is rarely prescribed, since it only reveals the presence of allergies.

When a representative of either sex feels severe pain and burning in the perineum, which can be constantly present 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 smear (sign up);
• Bacteriological culture of urine and urethral discharge;
• Analysis of blood or urethral discharge for the presence of pathogens of sexually transmitted infections ( for chlamydia (sign up), mycoplasma (sign up), gardnerella, ureaplasma (sign up), Trichomonas, gonococci, Candida fungi) by PCR or ELISA methods;
• Ultrasound of the bladder (sign up).

First of all, general blood and urine tests, a three-glass urine sample, a smear from the urethra and a culture of urethral discharge are prescribed. In the vast majority of cases, these tests allow us to identify the cause of urethritis, complete the examination and begin treatment. But if, with the help of such primary tests, it was not possible to identify the causative agent of the infectious-inflammatory process, then the doctor prescribes a blood test or urethral discharge for the presence of pathogens of sexually transmitted infections (for chlamydia, mycoplasma, gardnerella, ureaplasma, trichomonas, gonococci, Candida fungi) using methods PCR (sign up) or ELISA. Ultrasound of the bladder is prescribed only in cases where the doctor suspects that urethritis is complicated by cystitis.

When a representative of either sex suddenly develops a sharp pain in the perineum, combined with a burning sensation, severe sensitivity and a sensation of a foreign body in the pelvic organs, numbness on the inner thigh, and the symptoms intensify when walking, sitting and lying down, the doctor suspects a pinched pudendal nerve. In this case, the diagnosis is made mainly on examination data and characteristic symptoms. Additionally, to identify the cause of a pinched nerve, the doctor may prescribe magnetic resonance imaging. And in order to determine the speed of signal transmission along the nerve and the response of the muscles to the impulse, electroneurography is used, which makes it possible 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 bowel movements, possibly with the release of mucus, blood or pus from the rectum, chills and high body temperature - a disease of the terminal parts of the intestine (hemorrhoids) is suspected , rectal fissures, proctitis, paraproctitis). In this case, the doctor prescribes the following examinations:

• Examination of the anus and perineum;
• Digital rectal examination;
• General blood analysis;
• Scatological analysis of feces (with a reaction to occult blood);
• Feces on worm eggs;
• Analysis of stool for microflora (prescribed only if dysbacteriosis is suspected);
• A swab from the area around the anus (prescribed only if a fungal infection or genital herpes is suspected).

The above studies and tests are necessarily prescribed and performed first, and they provide the doctor with a fairly wide range of information about the condition of the terminal sections of the 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 additionally only anoscopy (sign up). But if proctitis, paraproctitis, rectal fissures are suspected, then anoscopy is prescribed, sigmoidoscopy (sign up)/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), probe examination, etc.

If pain in the perineum bothers a woman after childbirth, the doctor prescribes and performs an ultrasound, as well as gynecological two-manual examination (sign up) in order to identify deformations and 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 area of ​​the external genitalia (pubis, labia, penis, etc.), then it is suspected sexual infection (genital herpes, candidiasis). In this case, the doctor prescribes a smear from the urethra and vagina, bacteriological culture of vaginal and urethral discharge, which allows identifying the causative agent of the infection. If the results of these tests do not identify the causative agent of infection, then a blood test, urethral or vaginal discharge is prescribed for the presence of a pathogenic microbe (gonococcus, trichomonas, chlamydia, mycoplasma, ureaplasma, Candida fungi, 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, goes away on its own, does not intensify with prolonged existence, is not combined with other symptoms of 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 internal organs, this is a diagnosis of exclusion. In other words, a man or woman undergoes a full examination (general, biochemical blood tests, general urinalysis, blood clotting test, Ultrasound of the pelvic organs (if elevated body temperature increases with walking and straining, 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 examinations:

• General blood analysis;
• General urine analysis;
• Blood test to determine the level of prostate-specific antigen (PSA) (sign up);
• Digital examination of the prostate;
• Study of prostate secretion;
• Bacteriological culture of urine and prostate secretions;
• Urethral swab;
• Ultrasound of the prostate gland (make an appointment) And testicles (sign up);
• Testicular or prostate puncture with sampling biopsy (sign up).

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 initial 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.

Next, 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 additionally be prescribed to detect the presence of metastases or assess the condition of soft tissues. If fistulas are suspected, Urethroscopy (sign up), cystoscopy (make an appointment), anoscopy.

If the results of the initial tests reveal an inflammatory disease, the doctor prescribes a smear from the urethra, examination of prostate secretions, culture of urine and prostate secretions in order to identify the causative agent of the infectious-inflammatory process. Additionally, an ultrasound is performed to assess the condition of the genital organs.

If a man suffers from nagging, bursting pain in the perineum after sex, which radiates or is simultaneously felt in the testicles, is combined with discomfort, heaviness and visible veins of the scrotum, intensifies when walking, disappears spontaneously after a few hours - the doctor suspects a varicocele, and prescribes the following tests and examinations:

• Palpation of the testicle in a horizontal, vertical position and when straining;
• Spermogram (sign up);
• Venography;
• Kidney ultrasound (sign up) and testicles;
• Magnetic resonance imaging of the abdominal cavity (make an appointment);
• Dopplerography (sign up);
• Rheography (sign up).

First of all, the doctor prescribes and conducts palpation of the testicle, spermogram and venography, based on the data of which a diagnosis of varicocele is made. Ultrasound, Dopplerography and rheography of the testicles are considered additional examination methods, which are prescribed at the discretion of the doctor, but do not have high information content. Ultrasound of the kidneys and magnetic resonance imaging of the abdominal cavity are prescribed only to identify the possible cause of varicocele, which is often kidney pathology, vascular thrombosis, etc.

When a man develops a nagging, aching pain or burning sensation in the perineum, which is present almost constantly, intensifying in a sitting position and during defecation, cooperitis 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 secretions, urethral secretions and urine;
• Urethroscopy;
• X-ray contrast urethrography (sign up).

First of all, the doctor prescribes a general blood test and urine tests, microscopy of prostate secretions and smears from the urethra, as well as bacteriological culture of prostate secretions, urethral secretions and urine. These tests allow us to identify the causative agent of the infectious-inflammatory process. Next, urethroscopy is necessarily prescribed and performed, during which colliculitis can be diagnosed and distinguished from cooperitis. After urethroscopy, if cooperitis is detected, urethrography is performed to confirm it.

When a woman experiences pain in the perineum combined with itching, pain and abnormal vaginal discharge that gets worse with urination, the doctor suspects vaginitis and prescribes the following tests and examinations:

• Bimanual gynecological examination;
• Examination of the genitals in the mirrors;
• Vaginal smear for flora (sign up);
• Bacteriological culture of vaginal discharge;
• Detection of pathogens of sexually transmitted infections (chlamydia, mycoplasma, gardnerella, ureaplasma, trichomonas, gonococci, Candida fungi) in the blood and vaginal discharge using PCR and ELISA methods.

All these examinations are prescribed immediately and simultaneously, since they are necessary to identify the causative agent of the inflammatory process in the vagina.

When a woman suffers from throbbing pain in the perineum, which appears spontaneously or is 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 makes a diagnosis of based on examination of the patient. After identifying bartholinitis, treatment is carried out. If the process is ongoing for a long time, prone to chronicity, then a bacteriological culture of the discharge of the Bartholin gland is performed to determine 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 gland duct and removing the purulent contents. Such targeted prescription of antibiotics minimizes the risk of recurrent bartholinitis in the future.

Before use, you should consult a specialist.